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72 Pregnancy outcomes and glyceamic control in women with type 1 diabetes

      Introduction and aims of the study: Prevalence of type 1 diabetes (T1D) has increased in recent years which has led to increased number of pregnancies complicated with T1D. The aim of this study was to evaluate the latest pregnancy outcomes and glycaemic control in mothers with T1D. Methods: Retrospective record review of pregnancies with T1D booked between 2017-2018. Glycaemic control, rates of neonatal (large for gestational age - LGA, intrauterine growth restriction - IUGR, congenital malformations - CM) and maternal (preeclampsia, gestational hypertension - GH, caesarean section -CS and preterm delivery) outcomes were assessed. Results: Forty seven out of 54 women had continuous subcutaneous insulin infusion (CSII) (87%) and 7 had multiple daily injections (13%). Six women had HbA1c level higher than 6.9% (11%) at any point during pregnancy, 48 had HbA1c levels below 6.9% (89%) and 9 below 6.0% (16.7%) throughout whole pregnancy. Among 54 pregnancies 2 developed preeclampsia (3.7%) and 2 developed GH (3.7%). Four patients delivered prematurely (7.4%). Out of 47 patients that delivered at our clinic 2 had assisted vaginal delivery (4.2%), 1 shoulder dystocia (2.1%) and 18 delivered with CS (36%). Seventeen out of 48 neonates delivered at our clinic were LGA (35%), 7 were diagnosed with syndrome of diabetic mother (15%), 1 had IUGR (2.1%), 2 had birth injury (Erb palsy, clavicular fracture) (4.17%) and 8 were born with CM (16.7%). Among CM 3 (6.25%) were major type (cardiomyopathy, equinovarus) and 5 (10.4%) of minor type (hydrocele, non-neoplastic nevus, accessory ear). Conclusions: Considering small sample size bias there was increased rate of adverse pregnancy outcomes in women with T1D. Despite good glycaemic control with CSII treatment we observe high rate of LGA neonates and CM. With exception of two (accessory ear, non-neoplastic nevus) all types of CM in our group were previously linked to maternal diabetes.
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