Use of insulin pumps tied to preterm delivery, fetal overgrowth in pregnant women with type 1 diabetes: Study

For this purpose, the research team evaluated the risk of pregnancy and perinatal outcomes in a cohort of 2,003 pregnant women with T1D enrolled from 17 countries in a real-world setting during 2013–2018. 723 women were treated with pumps and 1,280 with MDI.

The study led to the following findings:

• At inclusion (median gestational weeks 8.6 [interquartile range 7–10]), pump users had lower mean HbA1c (mean 50.6 mmol/mol vs. 53.6 ± 13.8 mmol/mol), longer diabetes duration (18.4 versus 14.4 years), and higher prevalence of retinopathy (35.3% versus 24.4%).
• Proportions of large for gestational age offspring and preterm delivery were 59.0% vs. 52.2% (adjusted odds ratio [OR] 1.36) and 39.6% vs. 32.1% (adjusted OR 1.46), respectively.
• The results did not change after adjustment for HbA1c or gestational weight gain.

In conclusion, insulin pump treatment in pregnant women with type 1 diabetes, before the widespread use of continuous glucose monitoring or automated insulin delivery, was linked with a higher risk of LGA offspring and preterm delivery compared with MDI in crude and adjusted analyses.

This association was not attenuated after adjustment for gestational weight gain or HbA1c.

Reference:

Ida Holte Thorius, Lise Lotte N. Husemoen, Rikke Baastrup Nordsborg, Amra C. Alibegovic, Mari-Anne Gall, Janne Petersen, Peter Damm, Elisabeth R. Mathiesen; Fetal Overgrowth and Preterm Delivery in Women With Type 1 Diabetes Using Insulin Pumps or Multiple Daily Injections: A Post Hoc Analysis of the EVOLVE Study Cohort. Diabetes Care 23 February 2024; 47 (3): 384–392. https://doi.org/10.2337/dc23-1281