Päivi Kekäläinen1, Mari Juuti2, Tiina Walle3, Tiina Laatikainen4,5,6. 1. a Department of Internal Medicine , Hospital District of North Karelia , Joensuu , Finland . 2. b Department of Pediatrics , Hospital District of North Karelia , Joensuu , Finland . 3. c Department of Obstetrics and Gynecology , Hospital District of North Karelia , Joensuu , Finland . 4. d Institute of Public Health and Clinical Nutrition, University of Eastern Finland , Kuopio , Finland . 5. e Hospital District of North Karelia , Joensuu , Finland , and. 6. f Department of Chronic Disease Prevention , National Institute for Health and Welfare , Helsinki , Finland.
Abstract
OBJECTIVE: Pregnancy in women with type 1 diabetes is associated with increased risks. The aim of this study was to evaluate the effect of pregnancy planning on outcomes of type 1 diabetic pregnancies. METHODS: We retrospectively assessed pregnancy outcomes of type 1 diabetic women who were patients of Diabetes Clinic of North Karelia hospital between 2000 and 2012. We evaluated the medical records of 73 women experiencing 145 pregnancies and data of their infants. RESULTS: Altogether 96 (66.2%) pregnancies were planned. HbA1c levels were significantly lower before and during the whole pregnancy when pregnancy was planned than if it was not planned (all p <0.001). Planned pregnancies resulted in significantly fewer congenital anomalies (p <0.001). Pregnancy planning reduced the age-adjusted risk of Cesarean sections (OR 0.25, p = 0.021). Pregnancy planning was associated with a reduced risk of adverse pregnancy outcomes (including miscarriages and congenital anomalies). This association was independent of age, HbA1c before pregnancy, smoking, hypertension, microvascular complications, and thyroid disease (OR 0.26; 95% CI 0.09, 0.76). CONCLUSIONS: Pregnancy planning is beneficial for glycemic control and pregnancy outcomes of type 1 diabetic women. The benefit of pregnancy planning was independent of other risk factors for adverse pregnancy outcomes.
OBJECTIVE: Pregnancy in women with type 1 diabetes is associated with increased risks. The aim of this study was to evaluate the effect of pregnancy planning on outcomes of type 1 diabetic pregnancies. METHODS: We retrospectively assessed pregnancy outcomes of type 1 diabeticwomen who were patients of Diabetes Clinic of North Karelia hospital between 2000 and 2012. We evaluated the medical records of 73 women experiencing 145 pregnancies and data of their infants. RESULTS: Altogether 96 (66.2%) pregnancies were planned. HbA1c levels were significantly lower before and during the whole pregnancy when pregnancy was planned than if it was not planned (all p <0.001). Planned pregnancies resulted in significantly fewer congenital anomalies (p <0.001). Pregnancy planning reduced the age-adjusted risk of Cesarean sections (OR 0.25, p = 0.021). Pregnancy planning was associated with a reduced risk of adverse pregnancy outcomes (including miscarriages and congenital anomalies). This association was independent of age, HbA1c before pregnancy, smoking, hypertension, microvascular complications, and thyroid disease (OR 0.26; 95% CI 0.09, 0.76). CONCLUSIONS: Pregnancy planning is beneficial for glycemic control and pregnancy outcomes of type 1 diabeticwomen. The benefit of pregnancy planning was independent of other risk factors for adverse pregnancy outcomes.
Authors: Aoife M Egan; Sander Galjaard; Michael J A Maresh; Mary R Loeken; Angela Napoli; Eleni Anastasiou; Eoin Noctor; Harold W de Valk; Mireille van Poppel; Marie Todd; Valerie Smith; Declan Devane; Fidelma P Dunne Journal: Diabetologia Date: 2017-04-13 Impact factor: 10.122