Objective: Pregnancy in women with type I diabetes mellitus (T1DM) is associated with an increased risk of various obstetric complications. The purpose of this study was to evaluate relation of HbA1c, delivery age and various diabetes aspects on pregnancy outcome and gestation in women with T1DM.
Methods: This was a cross-sectional study. A total of 48 women hospitalized to the Hospital of Lithuanian University of Health Sciences Kauno klinikos Endocrinology Department were included. Diabetes control was assessed by HbA1C according to An Endocrine Society Clinical Practice Guidelines.
Results: In the 48 women with T1DM, the mean age was 28.7 years old (±6.1). Based on the area under Receiver operating characteristic (ROC) curve (59.6, P<0.05) the optimal age mean for pregnancy and successful delivery was 25 years old. It was found that only 27.1% of women in their first trimester of pregnancy with T1DM had good glycaemic control (HbA1c ≤6.5% (48 mmol/mmol)) and 72.9% had poor glycaemic control (HbA1c >6.6% (>49 mmol/mmol)). Moreover, it was a significantly increase of premature deliveries in women with poor glycemic control (P=0.002). To further explore pregnancy outcomes, we fit a logistic regression model to predict the risk of adverse birth outcomes. We found out that pregnant women with T1DM and older than 26 years old had 7.4 times higher risk for negative birth outcomes than younger women fitting the same criteria (P=0.034 (95% PI 1.1647.19).
Conclusion: This short study showed that glycemic control during pregnancy is insufficient in women with T1DM. We found out that poor glycemic control causes premature delivery (P<0.002) and age is an important risk factor for pregnancy outcome and gestation, among pregnant women with T1DM. Older than 26 years old women has 7.4 times higher risk for negative birth outcome.
20 - 23 May 2017
European Society of Endocrinology