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

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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… Click to show full 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: pregnancy; maternal foetal; type diabetes; type; retrospective comparison; type type

Journal Title: BMC Pregnancy and Childbirth
Year Published: 2021

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