1224-P: Diabetes in Teenage Pregnancy—Prevalence and Outcomes within a Population-Based Cohort

Diabetes and low maternal age are independently associated with an increased risk of adverse pregnancy outcomes. However, population data on prevalence and outcomes of diabetes in teenage pregnancy are limited. We used the Rochester Epidemiology Project to identify Olmsted County residents with a confirmed pregnancy <20 years of age from 2013-22. We identified 696 women (19.3% Hispanic), with 790 pregnancies. The average age at pregnancy was 17.9 ± 1.3 years and BMI was 26.6 ± 6.3 kg/m². In total, 37 pregnancies (4.7%) were affected by diabetes: 5 with type 1 (0.6%; population prevalence: 0.4%), 3 with type 2 (0.4%), 20 with GDM (2.5%; population prevalence: 18%), and 9 with impaired glucose tolerance (1.1%). Prepregnancy contraception was prescribed in 37.5% with prepregnancy diabetes versus 19.8% of those without (p=0.21), noting a prepregnancy HbA1c of 9.4 ± 3.0% in the subgroups with type 1 or 2 diabetes. Hypertensive disorders were higher in maternal diabetes (15.1 v 39.4%, nil diabetes v diabetes respectively, p<0.001). Live births occurred in 623 (82.7%) pregnancies compared to 32 (86.0%) in those with diabetes (p=0.55). Congenital anomaly rates were not higher in infants of women with diabetes (16.1 v 11.8%, p=0.52), but large for gestational age birthweights (6.2 v 15.6%, p= 0.03) and neonatal hypoglycemia were significantly higher (12.0 v 38.7%, p<0.001). Of those with GDM, 25% attended postpartum glucose testing. While the prevalence of diabetes in teenage pregnancy is relatively low, these data reveal that those affected are at significantly higher risk of adverse pregnancy outcomes and will benefit from targeted, multidisciplinary preconception and obstetric care.