Endocrine Abstracts

Objective: The aim of this study was to determine the prevalence of pregnancy planning in women with type 1 diabetes mellitus (DM1) and analysing differences associated with unplanned pregnancy.

Patients and methods: Retrospective descriptive study of pregnancies in women with DM1 (2004–2012). Variables analysed: age, time of diabetes evolution, microvascular complications, and maternal outcomes (HbA1c, preeclampsia, abortions, and Caesarean section) and neonatal outcomes (perinatal death, gestational age at delivery, birth weight, and congenital malformations). The pregnancies were divided in groups attending to pregnancy planning and were analysed to evaluate possible differences between them (group 1: planned and group 2: unplanned).

Statistical analysis: Comparing proportions with the χ² and comparing means with Student’s t-test.

Results: 132 pregnancies. Caucasian 99.2%. Unplanned pregnancy: 67.4%. Group 1 vs group 2: 31.84±4 years old vs 29±4.5 years old, P=0.34; time of diabetes evolution: 13.5±8.1 years vs 13.1±7.7 years, P=0.56; nonproliferative diabetic retinopathy: 4.6% vs 5.6%, P=0.5; proliferative diabetic retinopathy 9.3% vs 8.9%, P=0.9; microalbuminuria 0% vs 3.3%, P=0.22; nephropathy 0% vs 2.24%, P=0.32; hypertension 0% vs 2.24%, P=0.32; undertreated hypothyroidism: 23% vs 18.2%, P=0.45; smoking 7% vs 12.5%, P=0.33; HbA1c (%): before pregnancy 6.4±0.4 vs 8.04±1.3, P=0.00; first trimester 6.36±0.5 vs 7.6±1, P=0.004; second trimester 6.01±0.5 vs 6.63±1, P=0.01; and third trimester 6.14±6.77 vs 6.77±0.7, P=0.21. Maternal and neonatal outcomes (group 1 vs group 2): preeclampsia 0% vs 3.5%, P=0.21; abortions 6.9% vs 8.04%, P=0.7; Caesarean section 55% vs 44.8%, P=0.3; perinatal death 0% vs 1.1%, P=0.9; gestational age at delivery 38.5±1.8 weeks vs 37.8±2.4 weeks, P=0.1; macrosomia 25.6% vs 35%, P=0.28; neonatal hypoglycaemia 5% vs 5.3%, P=0.9; and congenital malformations 7.2% vs 7.3%, P=0.9.

Conclusions: Gestation planning is deficient and is associated with glycaemic control deficit at the beginning of gestation. Glycaemic control is similar in third trimester of pregnancy, and maternal and neonatal outcomes were similar in both groups.