Congenital malformations among offspring of women with type 1 diabetes who use insulin pumps: a prospective cohort study

Aims/hypothesis Continuous subcutaneous insulin infusion by insulin pump is often superior in improving glycaemic control compared with conventional multiple daily insulin injection (MDI). However, whether pump treatment leads to improved pregnancy outcomes in terms of congenital malformations and p...

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Bibliographic Details
Published in:Diabetologia 2023-05, Vol.66 (5), p.826-836
Main Authors: Thorius, Ida H., Husemoen, Lise Lotte N., Nordsborg, Rikke B., Alibegovic, Amra C., Gall, Mari-Anne, Petersen, Janne, Mathiesen, Elisabeth R.
Format: Article
Language:English
Subjects:
Cohort analysis
Congenital defects
Congenital diseases
Death
Diabetes
Diabetes mellitus (insulin dependent)
Diabetes Mellitus, Type 1 - drug therapy
Female
Fetuses
Folic acid
Glycated Hemoglobin
Human Physiology
Humans
Hypoglycemic Agents - therapeutic use
Infant, Newborn
Infusion pumps
Injections, Subcutaneous
Insulin
Insulin - therapeutic use
Insulin Infusion Systems
Internal Medicine
Medicine
Medicine & Public Health
Metabolic Diseases
Neonates
Offspring
Perinatal Death
Pregnancy
Prenatal development
Prospective Studies
Womens health
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Summary:Aims/hypothesis Continuous subcutaneous insulin infusion by insulin pump is often superior in improving glycaemic control compared with conventional multiple daily insulin injection (MDI). However, whether pump treatment leads to improved pregnancy outcomes in terms of congenital malformations and perinatal death remains unknown. The present aim was to evaluate the risk of malformations and perinatal and neonatal death in pregnant women with type 1 diabetes treated with pump or MDI. Methods We performed a secondary analysis of a prospective multinational cohort of 2088 pregnant women with type 1 diabetes in a real-world setting who were treated by pump ( n =750) or MDI ( n =1338). ORs for offspring with congenital malformations or perinatal or neonatal death were calculated using crude data and by logistic regression on propensity score-matched data. Results At enrolment (gestational week 8; 95% CI 4, 14), pump users had a higher educational level (university degree: 37.3% vs 25.1%; p
ISSN:0012-186X
1432-0428
DOI:10.1007/s00125-022-05864-6