Mortality in offspring of women with type 1 diabetes during pregnancy

Fetal and neonatal complications are common in pregnancies affected by maternal type 1 diabetes. The aim of this study is to investigate whether type 1 diabetes during pregnancy is reflected in offspring long-term mortality during a follow-up of up to 30 years.

This register-based follow-up study included 1762 offspring of women with type 1 diabetes (cases) and 8810 offspring of women without diabetes (controls). Time and causes of death between 1988 and 2018 were obtained from Statistics Finland. Clinical characteristics at birth of study participants and their mothers were obtained from the Finnish Medical Birth Register.

Cases had an 1,67 times higher mortality than controls during the 30-year follow-up period (crude HR 1.67 [95 % CI: 1.01-2.77]), with a median follow-up of 21 years (IQR 15-28). Cases possessed an adverse risk-profile at the neonatal stage. Endocrine, nutritional and metabolic diseases (IRR 5.02/100 000 person years [95 % CI 1.01-24.88]), and diseases of the nervous system (IRR 5.03/100 000 person years [95 % CI 1.16-21.82]) were overrepresented as the cause of death in this group.

These findings suggest that maternal type 1 diabetes during pregnancy is associated with higher mortality during a 30-year follow-up.