ECE2013 Poster Presentations Diabetes (151 abstracts)
Type 1 diabetes and pregnancy: importance of glycemic control in maternal and perinatal outcomes
Carolina Moreno 1 , Luísa Ruas 1 , Sandra Paiva 1 , Elvira Marta 2 , Sofia Gouveia 1 , Joana Saraiva 1 , Daniela Guelho 1 , Paulo Moura 2 , Manuela Carvalheiro 1 & Francisco Carrilho 1
1Department of Endocrinology, Diabetes and Metabolism. University Hospital of Coimbra, Coimbra, Portugal; 2Department of Obstetrics. University Hospital of Coimbra, Coimbra, Portugal.
Introduction: Type one diabetes is estimated to account for 1% of the pregnancies complicated by diabetes, associated with an increased risk of maternal and perinatal morbidity. The multidisciplinary follow up of the diabetic women can contribute to an improvement of the glycemic control, minimizing the obstetric and perinatal complications.
Aims: To characterize pregnant women with type one diabetes followed in our Department’s Endocrinology/Obstetrics Outpatient Clinic. To correlate their glycemic control with maternal and perinatal complications.
Methods: Retrospective analysis of clinical, analytical and therapeutic data of 158 pregnant women with type one diabetes followed between 1995 and 2012. Assessment of maternal complications, type of delivery and perinatal morbidity according to their glycemic control, using SPSS 21.0®.
Results: Sample of 158 women, mean age 28.7±5.3years, with type one diabetes for 11.8±7.2years, followed from 9.8±5.4weeks’ gestation, mean A1c in the 1st Trimester=7.7±1.5%, 2ndT=6.5±0.9% and 3rdT=6.6±0.9%.
Regarding the maternal outcomes: microvascular complications were worsened in 19 women (12.1%), only two episodes of diabetic ketoacidosis (1.3%). Pre-term delivery in 40 women (25.3%), pregnancy induced hypertension in 17 (10.8%), preeclampsia in 20 (12.7%).
Perinatal morbidity was significantly higher in women with A1c>7% in the 1st Trimester (39.4% Vs 22.5%;P=0.041), 2ndT(57% Vs 27.4%;P=0.007) and 3rdT(51.4% Vs 29.1%;P=0.033), when compared with women with adequate glycemic control (A1c=6-7%). Congenital malformations were significantly more prevalent in women with A1c>7% in the 1stT(9% Vs 0%;P=0.003), 2ndT(17.9% Vs 1.6%;P=0.004) and in the 3rdT(11.4% Vs 1.8%;P=0.048). There were two cases of stillbirths (1.3%) correlated with A1c>7% in the 3rdT (P=0.035).
Concerning the type of delivery, the rate of caesarean section was high (63.8%) and significantly superior in the women with excessive gestacional weight gain (P<0.001).
Conclusion: The prevalence of perinatal morbidity was significantly correlated with the glycemic control in all three trimesters, stressing the importance of a tight and permanent follow up of the pregnant women with type one diabetes.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more