Time trends in pregnancy-related outcomes among women with type 1 diabetes mellitus, 2004–2017

OBJECTIVE: To examine time trends in US pregnant women with type 1 diabetes mellitus for maternal characteristics and pregnancy outcomes. STUDY DESIGN: We abstracted clinical data from the medical records of 700 pregnant women from 2004 to 2017. For each time period, means and percentages were calcu...

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Detalles Bibliográficos
Autores principales: Helman, Sarit, James-Todd, Tamarra M., Wang, Zifan, Bellavia, Andrea, Wyckoff, Jennifer A., Serdy, Shanti, Halprin, Elizabeth, O’Brien, Karen, Takoudes, Tamara, Gupta, Munish, McElrath, Thomas F., Brown, Florence M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group US 2020
Materias:
Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7375951/
https://www.ncbi.nlm.nih.gov/pubmed/32488037
http://dx.doi.org/10.1038/s41372-020-0698-x
Descripción
Sumario:OBJECTIVE: To examine time trends in US pregnant women with type 1 diabetes mellitus for maternal characteristics and pregnancy outcomes. STUDY DESIGN: We abstracted clinical data from the medical records of 700 pregnant women from 2004 to 2017. For each time period, means and percentages were calculated. P values for trend were calculated using linear and logistic regression. RESULTS: HbA1c in each trimester was unchanged across the analysis period. The prevalence of nephropathy decreased from 4.8% to 0% (P = 0.002). Excessive gestational weight gain increased (P = 0.01). Gestation length also increased (P = 0.01), as did vaginal deliveries (P = 0.03). There were no change in birthweight over time (P = 0.07) and the percentage of neonates with macrosomia and large for gestational age (LGA) neonates also remained unchanged. CONCLUSION: Obstetric guideline changes may have improved gestation length and mode of delivery; however, other outcomes need more attention, including excessive gestational weight gain, macrosomia, and LGA.

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