Outcomes of pregnant women with overt diabetes comparable to those with pregestational diabetes

BRAZIL: According to a study that was published in Diabetology & Metabolic Syndrome, one-third of the cohort of pregnant women with hyperglycemia had overt diabetes diagnosed. Their pregnancy outcomes were comparable to those of women with pregestational diabetes and were mainly influenced by the maternal demographics and metabolic control.

Diabetes during pregnancy may have negative effects on the mother and the newborn. Although studies of pregnancies in women with type 2 diabetes have not included overtly diabetic women, they may be at an equal risk of negative outcomes as women with known pregestational diabetes.

In order to evaluate the primary pregnancy outcomes of women with overt diabetes to those of women with known pregestational type 2 diabetes, the researchers compared both groups of women in this study.

For this objective, from May 20, 2005, to June 30, 2021, they examined pregnant women with type 2 diabetes who were receiving high-risk prenatal care in two public hospitals in Southern Brazil. Results were obtained from digital medical records. The probability of unfavorable outcomes was determined using Poisson regression with reliable estimates, and the results were expressed as relative risk (RR) and 95% confidence interval (CI).

Major highlights of the study:

• Of the 618 women, 67% had pregestational diabetes and 33% had overt diabetes.
• The baseline maternal characteristics were related, with the exception of a slight, non-clinically significant difference in maternal age (33± 5.7 years in women with pregestational diabetes vs. 32± 6.0 years in women with overt diabetes, p = 0.004) and nearly twice as many women with overt diabetes reporting smoking (12.3% vs. 6.5%, p = 0.024) as those with pregestational diabetes.
• Considering pregnancy outcomes, there were no significant differences between the groups, however there was a tendency toward more neonatal critical care admissions in the pregestational diabetes group (45.2% vs. 36.1%, p = 0.051).

"Given that these women have a similar risk of unfavorable pregnancy outcomes to women with known diabetes, we should encourage steps for early detection of these women before conception," Angela Jacob Reichelt and team concluded.

Additionally, more needs to be done to raise awareness among the primary care health team about the advantages of preconception care among women of reproductive age, particularly when there is obesity or hyperglycemia.

REFERENCE

Oppermann, M.L., Campos, M.A., Hirakata, V.N. et al. Overt diabetes imposes a comparable burden on outcomes as pregestational diabetes: a cohort study. Diabetol Metab Syndr 14, 177 (2022). https://doi.org/10.1186/s13098-022-00939-1