Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2024

Open Access 01-12-2024 | Diabetes | Research

Prematurity and congenital malformations differ according to the type of pregestational diabetes

Authors: Monica Ballesteros, A Guarque, M Ingles, N Vilanova, M Lopez, L Martin, M Jane, L Puerto, M Martinez, M De la Flor, J Vendrell, A Megia

Published in: BMC Pregnancy and Childbirth | Issue 1/2024

Login to get access

Abstract

Background

Diabetes mellitus (DM) is the most common metabolic disorder in pregnancy. Women with Type 2 DM seems to have no better perinatal outcomes than those with Type 1 DM.

Methods

Single-center prospective cohort observational study. Pregnant women with diabetes (141 with Type 1 DM and 124 with Type 2 DM) that were followed in the university hospital between 2009 and 2021 were included in this study. Clinical data and obstetric and perinatal outcomes were collected.

Results

As expected, women with Type 1 DM were younger and had a longer duration of diabetes than women with Type 2 DM. Obesity and chronic hypertension were higher in the group of women with Type 2 DM and their value of HbA1c in the second and third trimesters were lower than in Type 1 DM. No differences in prematurity were found, but more extreme prematurity was observed in Type 2 DM, as well as a higher rate of congenital malformations. The frequency of hypoglycemia and the weight of the newborn was higher in Type 1 DM. The maternal independent factors related to the weight of the newborn were: the glycemic control at the third trimester, the weight gain during pregnancy, and pregestational BMI.

Conclusions

Newborns born to mothers with Type 1 DM were larger and had a higher frequency of hypoglycemia, while congenital malformations and precocious preterm was more associated to Type 2 DM. Metabolic control, weight gain and pregestational weight were important determinants of both obstetric and neonatal complications.
Literature
1.
go back to reference Abouzeid M, Versace VL, Janus ED, Davey MA, Philpot B, Oats J, Dunbar JA. A population-based observational study of diabetes during pregnancy in Victoria, Australia, 1999–2008. BMJ Open. 2014;4:e005394.CrossRefPubMedPubMedCentral Abouzeid M, Versace VL, Janus ED, Davey MA, Philpot B, Oats J, Dunbar JA. A population-based observational study of diabetes during pregnancy in Victoria, Australia, 1999–2008. BMJ Open. 2014;4:e005394.CrossRefPubMedPubMedCentral
2.
go back to reference Bardenheier BH, et al. Trends in pre-pregnancy diabetes among deliveries in 19 U.S. states, 2000–2010. Am J Prev Med. 2015;48:154–61.CrossRefPubMed Bardenheier BH, et al. Trends in pre-pregnancy diabetes among deliveries in 19 U.S. states, 2000–2010. Am J Prev Med. 2015;48:154–61.CrossRefPubMed
3.
go back to reference López-De-andrés A, Perez-Farinos N, Hernández-Barrera V, Palomar-Gallego MA, Carabantes-Alarcón D, Zamorano-León JJ et al. A population-based study of diabetes during pregnancy in Spain (2009–2015): Trends in incidence, obstetric interventions, and pregnancy outcomes. J Clin Med. 2020;9(2). López-De-andrés A, Perez-Farinos N, Hernández-Barrera V, Palomar-Gallego MA, Carabantes-Alarcón D, Zamorano-León JJ et al. A population-based study of diabetes during pregnancy in Spain (2009–2015): Trends in incidence, obstetric interventions, and pregnancy outcomes. J Clin Med. 2020;9(2).
4.
go back to reference Ornoy A. Effect of maternal diabetes on the embryo, fetus, and children: congenital anomalies, genetic and epigenetic changes and developmental outcomes. Birth Defects Res Part C Embryo Today Rev. 2015;105(1):53–72.CrossRef Ornoy A. Effect of maternal diabetes on the embryo, fetus, and children: congenital anomalies, genetic and epigenetic changes and developmental outcomes. Birth Defects Res Part C Embryo Today Rev. 2015;105(1):53–72.CrossRef
5.
go back to reference Murphy HR, Howgate C, O’Keefe J, Myers J, Morgan M, Coleman MA, et al. Characteristics and outcomes of pregnant women with type 1 or type 2 diabetes: a 5-year national population-based cohort study. Lancet Diabetes Endocrinol. 2021;9(3):153–64.CrossRefPubMed Murphy HR, Howgate C, O’Keefe J, Myers J, Morgan M, Coleman MA, et al. Characteristics and outcomes of pregnant women with type 1 or type 2 diabetes: a 5-year national population-based cohort study. Lancet Diabetes Endocrinol. 2021;9(3):153–64.CrossRefPubMed
6.
go back to reference Balsells M, García-Patterson A, Gich I, Corcoy R. Maternal and fetal outcome in women with type 2 versus type 1 diabetes mellitus: a systematic review and metaanalysis. J Clin Endocrinol Metab. 2009;94(11):4284–91.CrossRefPubMed Balsells M, García-Patterson A, Gich I, Corcoy R. Maternal and fetal outcome in women with type 2 versus type 1 diabetes mellitus: a systematic review and metaanalysis. J Clin Endocrinol Metab. 2009;94(11):4284–91.CrossRefPubMed
7.
go back to reference Gaudio M, Dozio N, Feher M, Scavini M, Caretto A, Joy M, et al. Trends in factors affecting pregnancy outcomes among women with type 1 or type 2 diabetes of childbearing age (2004–2017). Front Endocrinol (Lausanne). 2021;11(February):1–9. Gaudio M, Dozio N, Feher M, Scavini M, Caretto A, Joy M, et al. Trends in factors affecting pregnancy outcomes among women with type 1 or type 2 diabetes of childbearing age (2004–2017). Front Endocrinol (Lausanne). 2021;11(February):1–9.
8.
go back to reference Carrasco S, et al. Preconception care in diabetes: predisposing factors and barriers. Endocrinol Diabetes Nutr. 2017;65(3):164–71.CrossRef Carrasco S, et al. Preconception care in diabetes: predisposing factors and barriers. Endocrinol Diabetes Nutr. 2017;65(3):164–71.CrossRef
9.
go back to reference Guarnotta V, Mineo MI, Giacchetto E, Imbergamo MP, Giordano C. Maternal-foetal complications in pregnancy: a retrospective comparison between type 1 and type 2 diabetes mellitus. BMC Pregnancy Childbirth. 2021;21(1):1–10.CrossRef Guarnotta V, Mineo MI, Giacchetto E, Imbergamo MP, Giordano C. Maternal-foetal complications in pregnancy: a retrospective comparison between type 1 and type 2 diabetes mellitus. BMC Pregnancy Childbirth. 2021;21(1):1–10.CrossRef
11.
go back to reference GEDE. Grupo Español de Diabetes y Embarazo (GEDE). Diabetes mellitus y embarazo Guía De práctica clínica actualizada2020. Prog Obs Ginecol. 2022;65:35–41. GEDE. Grupo Español de Diabetes y Embarazo (GEDE). Diabetes mellitus y embarazo Guía De práctica clínica actualizada2020. Prog Obs Ginecol. 2022;65:35–41.
13.
go back to reference Committee on Obstetric Practice AC of O and G. Weight gain during pregnancy: committee opinion 548. 2013. Committee on Obstetric Practice AC of O and G. Weight gain during pregnancy: committee opinion 548. 2013.
14.
15.
go back to reference Stogianni A, Lendahls L, Landin-Olsson M, Thunander M. Obstetric and perinatal outcomes in pregnancies complicated by diabetes, and control pregnancies, in Kronoberg, Sweden. BMC Pregnancy Childbirth. 2019;19(1). Stogianni A, Lendahls L, Landin-Olsson M, Thunander M. Obstetric and perinatal outcomes in pregnancies complicated by diabetes, and control pregnancies, in Kronoberg, Sweden. BMC Pregnancy Childbirth. 2019;19(1).
16.
go back to reference Murphy HR. Improved pregnancyoutcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study. Diabetologia. 2017;60:1668–77.CrossRefPubMedPubMedCentral Murphy HR. Improved pregnancyoutcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study. Diabetologia. 2017;60:1668–77.CrossRefPubMedPubMedCentral
17.
go back to reference Schaefer-Graf U. Diabetic pregnancy study group.diabetes in pregnancy: a new decade of challenges ahead. Diabetologia. 2018;61:1012–21.PubMedPubMedCentral Schaefer-Graf U. Diabetic pregnancy study group.diabetes in pregnancy: a new decade of challenges ahead. Diabetologia. 2018;61:1012–21.PubMedPubMedCentral
18.
go back to reference WilsonRD. Preconception folic acid and multivitamin supplementation for the primary and secondary prevention of neural tube defects and other folic acid sensitive congenital anomalies. JOGC. 2015;37(6):534–52. WilsonRD. Preconception folic acid and multivitamin supplementation for the primary and secondary prevention of neural tube defects and other folic acid sensitive congenital anomalies. JOGC. 2015;37(6):534–52.
19.
go back to reference Wahabi H. Pre-pregnancy care for women with pre-gestational diabetes mellitus: a systematic review and meta-analysis. BMC Public Heal. 2012;17(12):792.CrossRef Wahabi H. Pre-pregnancy care for women with pre-gestational diabetes mellitus: a systematic review and meta-analysis. BMC Public Heal. 2012;17(12):792.CrossRef
20.
go back to reference Melamed N. Perinatal mortality in pregestational diabetes. Int JGynaecol Obs. 2009;104(Suppl 1):S20–4. Melamed N. Perinatal mortality in pregestational diabetes. Int JGynaecol Obs. 2009;104(Suppl 1):S20–4.
21.
go back to reference Allen AJ. Type-2 diabetes mellitus: does prenatal care affect outcomes? J Matern Neonatal Med. 2017;15:1–5. Allen AJ. Type-2 diabetes mellitus: does prenatal care affect outcomes? J Matern Neonatal Med. 2017;15:1–5.
22.
go back to reference Hillman N. Is pregnancy outcome worse in type 2 than in type1 diabetic women. Diabetes Care. 2006;29:2557–8.CrossRefPubMed Hillman N. Is pregnancy outcome worse in type 2 than in type1 diabetic women. Diabetes Care. 2006;29:2557–8.CrossRefPubMed
23.
go back to reference Søholm JC, Vestgaard M, Ásbjörnsdóttir B, Do NC, Pedersen BW, Storgaard L, et al. Potentially modifiable risk factors of preterm delivery in women with type 1 and type 2 diabetes. Diabetologia. 2021;64(9):1939–48.CrossRefPubMed Søholm JC, Vestgaard M, Ásbjörnsdóttir B, Do NC, Pedersen BW, Storgaard L, et al. Potentially modifiable risk factors of preterm delivery in women with type 1 and type 2 diabetes. Diabetologia. 2021;64(9):1939–48.CrossRefPubMed
24.
go back to reference Kong L, Nilsson IAK, Gissler M, Lavebratt C. Associations of maternal diabetes and body mass index with offspring birth weight and prematurity. JAMA Pediatr. 2019;173(4):371–8.CrossRefPubMedPubMedCentral Kong L, Nilsson IAK, Gissler M, Lavebratt C. Associations of maternal diabetes and body mass index with offspring birth weight and prematurity. JAMA Pediatr. 2019;173(4):371–8.CrossRefPubMedPubMedCentral
25.
go back to reference Ladfors L et al. Fetal overgrowth in women with type 1 and type 2 diabetes mellitus. PLoS ONE. 2017;12(11). Ladfors L et al. Fetal overgrowth in women with type 1 and type 2 diabetes mellitus. PLoS ONE. 2017;12(11).
Metadata
Title
Prematurity and congenital malformations differ according to the type of pregestational diabetes
Authors
Monica Ballesteros
A Guarque
M Ingles
N Vilanova
M Lopez
L Martin
M Jane
L Puerto
M Martinez
M De la Flor
J Vendrell
A Megia
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2024
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-024-06470-7

Other articles of this Issue 1/2024

BMC Pregnancy and Childbirth 1/2024 Go to the issue