1062-P: Outcomes in Pregnancies with Preexisting Type 1 Diabetes vs. Healthy Controls over a 14-Year Period

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.