Glycosylated Haemoglobin and Adverse Pregnancy Outcomes in Women with Diabetes Mellitus Type 1 Compared to Pregnancies in the General Population

Aim: to compare pregnancy outcomes in type 1 diabetic pregnancies with the general population and the impact of glycemic control (HbA1c) on pregnancy outcomes.
Material and methods: The study group included 55 consecutive pregnant women with type 1 diabetes who attended the Outpatient department of Endocrinology, Diabetes and Metabolic disorders in their first trimester of pregnancy. For comparison, data of 22767 deliveries in 2004 year were used, published in “Perinatal outcomes in Republic of Macedonia for year 2004”. The following parameters were studied: age, maternal body mass index, diabetes duration, planning of pregnancy, HbA1c values in first, second and third trimester, pre-eclampsia, birth weight, gestational age at delivery, mode of delivery, and pregnancy outcomes (spontaneous abortions, perinatal mortality, and major congenital malformations).
Results: The perinatal mortality rate was 10,9% and congenital malformation rate was 7,3%, in type 1 diabetic pregnancies compared with 1,1% and 1,9%, respectively in the general population. Macrocosmic babies were born in 9,1% of type 1 diabetic pregnancies compared with 1,01% in the general population. The caesarean section rate was 61,8% and 16,1%, respectively, and the preterm delivery rate was 25,5% and 6,1%, respectively. Pregnancies with serious adverse outcomes (spontaneous abortion, perinatal mortality and congenital malformations) were characterized by higher
Values of HbA1c in the first trimester of diabetes type 1 pregnancies
Conclusion: Type 1 diabetic pregnancies have worse outcomes then general population. Planning of pregnancy and rigorous glycaemic control using glucose monitoring before and during early pregnancy are crucial for better pregnancy outcomes.
Key words: pregnancy outcomes, diabetes mellitus type 1, glycated haemoglobin, congenital malformations.