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Time trends in pregnancy-related outcomes among women with type 1 diabetes mellitus, 2004-2017
Sarit Helman1, Tamarra M James-Todd2,3, Zifan Wang3
1Harvard Medical School, Boston, MA, USA.
Objective:
To examine time trends in US pregnant women with type 1 diabetes mellitus for maternal characteristics and pregnancy outcomes.
Study Design:
We abstracted clinical data from the medical records of 700 pregnant women from 2004 to 2017. For each time period, means and percentages were calculated. P values for trend were calculated using linear and logistic regression.
Results:
HbA1c in each trimester was unchanged across the analysis period. The prevalence of nephropathy decreased from 4.8% to 0% (P = 0.002). Excessive gestational weight gain increased (P = 0.01). Gestation length also increased (P = 0.01), as did vaginal deliveries (P = 0.03). There were no change in birthweight over time (P = 0.07) and the percentage of neonates with macrosomia and large for gestational age (LGA) neonates also remained unchanged.
Conclusion:
Obstetric guideline changes may have improved gestation length and mode of delivery; however, other outcomes need more attention, including excessive gestational weight gain, macrosomia, and LGA.
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