279 - Impact of pre-pregnancy body mass index on maternal and fetal outcomes in type 1 diabetitc preganancy (T1DM)

279 - Impact of pre-pregnancy body mass index on maternal and fetal outcomes in type 1 diabetitc preganancy (T1DM). American Journal Obstet and Gynecol. Suppl.Jan 2013, 278, S126.
Luisa Patanè, Serena Pirola , Santa Barresi , Giorgia Cavalli , Nicola Strobelt, Luigi Frigerio , Alessandro Roberto Dodesini, Roberto Trevisan, Elena Ciriello. Ospedali Riuniti di Bergamo, Obstetrics and Gynecology, Bergamo, Italy.

OBJECTIVE: Our objective was to asses the risk of maternal and perinatal complications in a T1DM pregnancy group and their relationships with pre-pregnacy BMI.

STUDY DESIGN: We retrospectively reviewed the data-charts of singleton T1DM pregnancies who delivered in our hospital between May 2004 and July 2012. Patients were divided in two groups according to BMI: normal weight (BMI25) and overweight (BMI25). Maternal and fetal outcomes were statistically analyzed and compared through Fisher’s test and T-test.

RESULTS: During the study period 80 patients with T1DM delivered in our hospital, 55 (69 %) had normal weight, 25 (31%) were over- weigth. Maternal characteristics (parity, maternal age, duration of diabetes, pre-pregnancy diabetic complications) were statistically similar between the two groups. Fourty-eight patients had continuous subcutaneous insulin infusion (CSII) and 32 multiple daily injections(MDI) with no different distribution among the groups. The delivery mode was significantly different between the two groups, with a higher incidence of cesarean section in the overweight group (16/25 vs 24/55; p 0,04). The other obstetric outcomes (pre-eclampsia, thiroyd disease, preterm delivery, fetal malformation) were not affected by BMI. The overweight group had a significant increase on HbA1c levels during second and third trimester of pregnancy (Table). The two groups were not significantly different in terms of neonatal out-comes (neonatal weight, number of LGA, umbilical artery pH, Apgar at 5’, neonatal intensive care need, perinatal mortality).

CONCLUSION: In our population the overweighted patients had a higher incidence of cesarean delivery. High pre-pregnancy BMI was correlated with a significantly increase of HbA1c, levels from the sec- ond trimester till the end of pregnancy, with no effect on the rate of adverse neonatal outcomes.