Background: We studied maternal and neonatal outcomes in pregnancies with preexisting T1D and matched controls (age, gravida, BMI) to address limited data in this field in the US.

Methods: Pregnancies (n=165) in preexisting T1D and matched healthy controls (n=165) were retrospectively studied (01/01/20to 12/1/2020) at a single center. Conditional logistic regression, Wilcoxon signed rank and Wilcoxon rank sum tests were used for analyses.

Results: Pregnancies with T1D had significant hypertension [32% (19% pre-existing) vs. 10% (2% pre-existing) , p<0.01], preeclampsia (28% vs. 7%, p<0.01) , thyroid dysfunction (24% vs. 7%, p<0.01) and were affected by polyhydramnios (14% vs. 4%, p<0.01) , macrosomia affecting labor (16% vs. 2%, p<0.01) , increased C-section’s rate (16% vs. 7%, p=0.02) and complicated C- sections (6% vs. 1%, p=0.04) . In T1D, four neonates had cardiac complications and 14 (8.5%) were large for gestational age compared to 2 (1%) controls. More neonates in T1D were preterm (34.5% vs. 14.5%, p<0.01) , with fetal anomalies (15.8% vs. 4%, p<0.01) , Respiratory Distress Syndrome (25.5% vs. 7%, p<0.01) , apnea (14% vs 5.5%, p=0.01) , other pulmonary complications (13% vs. 5%, p<0.01) and respiratory failure (11% vs. 3%, p=0.01) . Significant hypoglycemia (16% vs. 7%) , sepsis (7% vs. 1%) , jaundice (70% vs. 36%) and upper GI complications (39% vs. 16%) were observed in neonates born to mothers with T1D. T1D neonates had higher birth weight (p =0.01) and were born early (37.2 vs. 39 wks, p<0.01) . HbA1c >7% was associated with above neonatal complications compared to those who with HbA1c <6.7%.

Conclusion: Pregnancies with type 1 diabetes continue to be associated with high maternal and neonatal morbidity and need urgent development of interventions to improve outcomes.


R.Kaur: None. S.Rizvi: None. D.Desjardins: None. I.Zaniletti: None. C.Reid: None. S.K.Mccrady-spitzer: None. M.Trinidad: None. Y.C.Kudva: Advisory Panel; Novo Nordisk, Research Support; Dexcom, Inc., Hemsley Charitable Trust, JDRF, National Institutes of Health, Roche Diabetes Care, Tandem Diabetes Care, Inc.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at