Maternal and Perinatal Outcomes in Pregnancies With Type 1 Diabetes and Controls During a 15-Year Period (2006-2020)

To study contemporaneous pregnancy outcomes in women with Type 1 Diabetes (T1D).

We retrospectively studied maternal and perinatal outcomes in women with T1D, and their age and gravidity matched healthy controls (N=161 pairs) who were admitted to Mayo Clinic, Rochester, MN, for delivery from January 01, 2006, to December 31, 2020, and provided research authorization for access to medical records. Data were initially electronically retrieved with subsequent manual review.

We assessed 13 maternal and 22 perinatal outcome variables in 161 women with T1D and 161 healthy women matched on relevant variables. The combined study population had a mean age of 29±5 years, basic metabolic index (BMI) of 27.5±6 kg/m², with a mean glycated hemoglobin in the T1D group of 7.74±1.64, 6.67±1.11, and 6.93±3.1 in the first, second and third trimesters, respectively. Preeclampsia, hypothyroidism, polyhydramnios, induced premature labor and preterm delivery (including medically indicated), and cesarean section were more common in women with T1D. Perinatal outcomes more prevalent among T1D pregnancies were preterm delivery, large for gestational age, cardiac (structural and functional defects), upper gastrointestinal complications, jaundice, neonatal hypoglycemia treated with intravenous dextrose only, hypoxia, respiratory distress syndrome with or without respiratory failure, and neonatal sepsis.

Pregnancies with T1D continue to be associated with suboptimal glycemic control and higher maternal and perinatal morbidity, as compared to pregnancies in women without T1D, reinforcing the urgent need for the development of interventions to improve pregnancy outcomes.