To identify whether there were any differences between the outcomes of pregnancy in women with pre-gestational diabetes that were under endocrine follow-up prior to pregnancy, compared to those who present whilst pregnant and without regular follow-up.
We identified women with type 1 and type 2 diabetes who delivered over a two year period and were managed by the maternity services in a major tertiary hospital. We compared neonatal ICU admissions, neonatal hypoglycaemia, pre-term delivery, birthweight and large and small for gestational age neonates. Outcomes were compared for women known to our service and those who were regarded as not having received adequate pre-conception care.
30 pregnancies with in women with type 1 diabetes were identified. 12 pregnancies in women with type 2 diabetes were identified. No differences were identified in outcomes between the two groups although there was a tendency to pre-term delivery in those without adequate pre-conception care, with 62.5% of the Type 1 cohort not under active follow-up requiring pre-term delivery, compared to 35% of the Type 1 cohort without regular follow-up requiring pre-term delivery. Combining the type 1 & type 2 cohort showed 50% of those without adequate pre-conceptual follow-up required pre-term delivery, while 25% of those with adequate follow-up required pre-term delivery. (p = 0.10).
We did not demonstrate any differences in outcome for women with pre-gestational diabetes with or without ‘adequate’ pre-conception care. Small numbers may have had some impact on outcomes but birthweight and neonatal hypoglycaemia seemed comparable.