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Nov 8, 2017

International Diabetes Federation 2017 Congress

Glycemia controls during pregnancy and pre-pregnancy BMI on the risk of newborn macrosomia in patients with T1DM

;

Kopaleishvili;

A.;

Asatiani;

N.;

Kurashvili;

R.;

Dundua;

M.;

Shelestova;

E.;

Inashvili;

E.;

Hod;

M.

pregnancy

type 1 diabetes

weight

infant

Abstract

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Abstract

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Keywords

pregnancy

type 1 diabetes

weight

infant

Abstract

The aim of the present work was to reveal correlation between glycemia indices, pre-pregnancy body mass index (BMI) in pregnant patients with type 1 diabetes mellitus (T1DM) and their infants’ birth weight (IBW). Methods: Totally, 277 pregnant women with T1DM were enrolled in the study (mean age - 277yrs; diabetes duration – 11.2 5.4yrs). Patients with nephropathy were excluded. Strict metabolic control was maintained and fetal surveillance was performed throughout the pregnancies. Data obtained for home-blood glucose monitoring (seven-point profiles), postprandial (PG), fasting (FG), mean blood glucose (MG), HbA1c in the 3rd trimester of pregnancy were analysed. Healthy infants were born to diabetic mothers at 38-40 week of gestation. According to the IBW, the patients were devided into 2 groups (GR): GR.1 - n=201, IBW < 4 000g; Gr. 2 - n=76, IBW >4 000g. Results. Healthy infants were born to diabetic mothers at 38-40 week of gestation. Their birth weight was 3 383 ± 358.3g in Gr.1 and 4 218 ±414.3g in Gr.2. Macrosomia (BW >4 000 g) was observed in 76 (27.4%) out of the 277 newborns. In the 3rd trimester of pregnancy - HbA1c (%), PG, FG and MG (mg/dl) levels were statistically higher in GR.2, than in Gr.1: HbA1c (7.2 ±1.38 vs 6.1± 1.71, P<0.001), PG (P=0.000), FG (P=0.000), MG (P=0.000), Table 1, Fig.1. Pre-pregnancy BMI (kg/m2) indices were higher in Gr.2, than in Gr.1 ( 27.2± 0.58 vs 22.5± 0.62; P<0.001), Table 1. Gr.1 In Gr.1 we observed week correlation between IBW and pre-pregnancy BMI (r-0.418; P=0.01), and no significant interaction between IBW and HbA1c, FG,PG,MG, (Fig.2). Gr.2 In Gr.2 we observed strong correlation between IBW and PG (r-0.882; P=0.000), IBW and pre-pregnancy BMI (r-0.866; P=0.001), Table 1, Fig.4,5. In Gr.2 we observed strong week correlations between IBW and HbA1c ( r-0.593;P=0.03), IBW and MG (r-0.611;P=0.002), and no correlation between IBW and FG, Table.1, Fig.3 Summary. In women with T1DM, in the 3rd trimester of pregnancy, fasting, mean glycemia and HbA1c - do not always predict increase in fetal weight, while pre-pregnancy BMI and postprandial glycemia significantly associated with macrosomoia.

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All rights reserved.