Prematurity and congenital malformations differ according to the type of pregestational diabetes

BMC Pregnancy Childbirth. 2024 May 2;24(1):335. doi: 10.1186/s12884-024-06470-7.

Abstract

Background: Diabetes mellitus (DM) is the most common metabolic disorder in pregnancy. Women with Type 2 DM seems to have no better perinatal outcomes than those with Type 1 DM.

Methods: Single-center prospective cohort observational study. Pregnant women with diabetes (141 with Type 1 DM and 124 with Type 2 DM) that were followed in the university hospital between 2009 and 2021 were included in this study. Clinical data and obstetric and perinatal outcomes were collected.

Results: As expected, women with Type 1 DM were younger and had a longer duration of diabetes than women with Type 2 DM. Obesity and chronic hypertension were higher in the group of women with Type 2 DM and their value of HbA1c in the second and third trimesters were lower than in Type 1 DM. No differences in prematurity were found, but more extreme prematurity was observed in Type 2 DM, as well as a higher rate of congenital malformations. The frequency of hypoglycemia and the weight of the newborn was higher in Type 1 DM. The maternal independent factors related to the weight of the newborn were: the glycemic control at the third trimester, the weight gain during pregnancy, and pregestational BMI.

Conclusions: Newborns born to mothers with Type 1 DM were larger and had a higher frequency of hypoglycemia, while congenital malformations and precocious preterm was more associated to Type 2 DM. Metabolic control, weight gain and pregestational weight were important determinants of both obstetric and neonatal complications.

Keywords: Diabetes; High-risk pregnancy; Maternal-fetal medicine; Obesity; Pregnancy; Preterm delivery.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Birth Weight
  • Body Mass Index
  • Congenital Abnormalities* / epidemiology
  • Diabetes Mellitus, Type 1* / blood
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / epidemiology
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypoglycemia / epidemiology
  • Hypoglycemia / etiology
  • Infant, Newborn
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Pregnancy in Diabetics* / epidemiology
  • Premature Birth* / epidemiology
  • Prospective Studies

Substances

  • Glycated Hemoglobin