Assessment of the effect of pregnancy planning in women with type 1 diabetes treated by insulin pump

Autor: Daniela Bruttomesso, Lucie Mourou, Valeria Vallone, Francesco Cavallin, Eric Renard, Silvia Galasso, Florent Fuchs, Cécile Brunet, Federico Boscari, Eleonora Vania
Přispěvatelé: Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), University of Padova [Padoue, Italie], Institut de Génomique Fonctionnelle (IGF), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), Fuchs, Florent, CHU Montpellier, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Università degli Studi di Padova = University of Padua (Unipd), Department Statistics [sologna, Italia] (DS)
Rok vydání: 2020
Předmět:
Male
Endocrinology
Diabetes and Metabolism
[SDV]Life Sciences [q-bio]
Pregnancy in Diabetics
Iatrogenic preterm delivery
030204 cardiovascular system & hematology
Preconception Care
Infant
Newborn
Diseases
0302 clinical medicine
Endocrinology
Pregnancy
Insulin
Insulin pump
Planning
Pregnancy outcomes
Type 1 diabetes
Obstetrics
Pregnancy Outcome
Pregnancy
Unplanned
General Medicine
Prognosis
3. Good health
Italy
Family Planning Services
Female
France
Adult
medicine.medical_specialty
030209 endocrinology & metabolism
Glycemic Control
[SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics
Preeclampsia
03 medical and health sciences
Insulin Infusion Systems
Intensive care
Diabetes mellitus
Internal Medicine
medicine
Humans
Retrospective Studies
Fetus
business.industry
Infant
Newborn
medicine.disease
[SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics
Diabetes Mellitus
Type 1
latrogenic preterm delivery
business
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Zdroj: Acta Diabetologica
Acta Diabetologica, Springer Verlag, 2020, 58 (3), pp.355-362. ⟨10.1007/s00592-020-01620-7⟩
Acta Diabetologica, 2021, 58 (3), pp.355-362. ⟨10.1007/s00592-020-01620-7⟩
ISSN: 1432-5233
0940-5429
DOI: 10.1007/s00592-020-01620-7⟩
Popis: International audience; Background: Pregnant women with type 1 diabetes (T1D) have high risk of complications despite improved care based on technology advancements.Objective: To assess the effects of pregnancy planning on fetal and maternal outcomes in T1D women treated with continuous subcutaneous insulin infusion (CSII).Study design: We retrospectively assessed maternal and neonatal outcomes in T1D women using CSII who had planned or unplanned pregnancies between 2002 and 2018. The study was done in two European countries with similar sustained programs for pregnancy planning over the study period.Results: Data from 107 pregnancies and newborn babies were collected. Seventy-nine pregnancies (73.8%) had been planned. HbA1c was lower in planned versus unplanned pregnancy before and during all three trimesters of pregnancy (p < 0.0001). Pregnancy planning was associated with a reduction in the occurrence of iatrogenic preterm delivery (RR 0.44, 95% CI 0.23-0.95; p = 0.01). Risk reduction persisted after adjustments for mother's age above 40 years and preeclampsia. High HbA1c before or during pregnancy was associated with an increased risk of iatrogenic preterm delivery (RR 3.05, 95% CI 1.78-5.22, p < 0.0001). Premature newborns needed intensive care more often than those at term (RR 3.10, 95% CI 1.53-4.31; p = 0.002).Conclusions: Pregnancy planning in T1D women using CSII was associated with better glucose control and decreased risk of iatrogenic preterm delivery. Hence preconception care also improves pregnancy outcome in patients using an advanced mode of insulin delivery. Planned pregnancies could further benefit from the use of new metrics of glucose control.
Databáze: OpenAIRE
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