The following is a summary of “Pregnancy Outcomes in Type 2 Diabetes: a systematic review and meta-analysis,” published in the December 2024 issue of Obstetrics and Gynecology by Clement et al.
Type 2 diabetes mellitus (T2DM) now represents the most common pre-existing form of DM affecting individuals during pregnancy in the UK, necessitating an understanding of the impact compared to type 1 diabetes mellitus (T1DM), gestational diabetes mellitus (GDM), and pregnancy without DM.
Researchers conducted a retrospective study to evaluate pregnancy outcomes among individuals with T2DM compared to those with T1DM, GDM, and individuals without DM.
They conducted a PubMed search (January 2009–2024; PROSPERO ID CRD42023411057), including at least 10 pregnancies involving individuals with T2DM. Outcomes such as congenital anomalies, stillbirth, neonatal mortality, perinatal mortality, and measures of growth, including large for gestational age (LGA), small for gestational age (SGA), and macrosomia were reported.
The results showed that pregnancies affected by T2DM were associated with increased risks of SGA births (OR 2.29, 95% CI 1.12–4.67), neonatal mortality (OR 1.53, 95% CI 1.20–1.94), and perinatal mortality (OR 1.31, 95% CI 1.07–1.61) compared to pregnancies affected by T1DM. Compared to GDM, pregnancies affected by T2DM were linked to higher risks of congenital anomalies (OR 1.91, 95% CI 1.04–3.50), LGA births (OR 3.49, 95% CI 2.49–4.89), neonatal mortality (OR 3.96, 95% CI 3.38–4.64), and stillbirth (OR 16.55, 95% CI 5.69–48.11). Compared to pregnancies in individuals without DM, pregnancies affected by T2DM were associated with high risks of congenital anomalies (OR 1.76, 95% CI 1.11–2.79), large for gestational age births (OR 2.79, 95% CI 1.93–4.04), perinatal mortality (OR 4.18, 95% CI 2.91–6.01), and stillbirth (OR 7.27, 95% CI 3.01–17.53).
They concluded that pregnancies affected by T2DM had higher perinatal mortality and adverse outcomes, emphasizing the need for better awareness and care.
Source: ajog.org/article/S0002-9378(24)01176-1/fulltext
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