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Comparative Study
. 2021 Mar 22;21(1):243.
doi: 10.1186/s12884-021-03702-y.

Maternal-foetal complications in pregnancy: a retrospective comparison between type 1 and type 2 diabetes mellitus

Valentina Guarnotta #  1 , Mariagrazia Irene Mineo #  1 , Emanuela Giacchetto  1 , Maria Pia Imbergamo  1 , Carla Giordano  2
Affiliations
Comparative Study

Maternal-foetal complications in pregnancy: a retrospective comparison between type 1 and type 2 diabetes mellitus

Valentina Guarnotta et al. BMC Pregnancy Childbirth. .

Abstract

Background: The aim of the study was a retrospective comparison of the differences in maternal-foetal outcomes between women with type 1 and type 2 diabetes mellitus (T1DM and T2DM).

Methods: A cohort of 135 patients with pregestational diabetes, 73 with T1DM (mean age 29 ± 5 years) and 62 with T2DM (mean age 33 ± 6 years), in intensive insulin treatment throughout pregnancy were evaluated. Clinical and metabolic parameters and the prevalence of maternal and foetal complications were assessed.

Results: Women with T1DM showed lower pregestational BMI (p < 0.001), pregestational weight (p < 0.001), weight at delivery (p < 0.001), ∆_total_insulin requirement (IR) at the first, second and third trimesters (all p < 0.001) and higher weight gain during pregnancy (p < 0.001), pregestational HbA1c (p = 0.040), HbA1c in the first (p = 0.004), second (p = 0.020) and third (p = 0.010) trimesters compared to T2DM. Women with T1DM had a higher risk of macrosomia (p = 0.005) than T2DM, while women with T2DM showed higher prevalence of abortion (p = 0.037) than T1DM. At multivariate analysis, pregestational BMI and ∆_total_IR of the first trimester were independently associated with abortion in T2DM, while weight gain during pregnancy was independently associated with macrosomia in T1DM.

Conclusion: Women with T1DM have a higher risk of macrosomia than T2DM due to weight gain throughout pregnancy. By contrast, women with T2DM have a higher risk of spontaneous abortion than T1DM, due to pregestational BMI and ∆_total_IR in the first trimester.

Keywords: Abortion; Insulin requirement; Large for gestational age; Macrosomia.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Total daily insulin requirements measured in units/kg during pregnancy (first, second and third trimesters) in type 1 and type 2 diabetes mellitus (T1DM and T2DM). Change (∆) from end to start of each trimester for insulin requirement (IR) in women with T1DM and T2DM
Fig. 2
Fig. 2
a HbA1c in preconception and during trimesters in pregnant women with T1DM (dark grey) vs. T2DM (light grey). Values are mean ± SD. Student’s test was used to evaluate the differences between the groups. b Number of pregnant women with T1DM and T2DM who experienced hypoglycaemic events during first, second and third trimester
Fig. 3
Fig. 3
Average fasting and postprandial glycaemia obtained from SMBG in pregnant women with T1DM and T2DM. Data are presented as mean ± SD values. Student’s test was used to evaluate the differences between the groups. FPG: fasting plasma glucose. PBG: postprandial breakfast glucose. PLG: postprandial lunch glucose. PDG: postprandial dinner glucose. NS: not significant
See this image and copyright information in PMC

References

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