Oral Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2023

Impact of Concurrent Type 1 Diabetes and Obesity on Adverse Maternal and Neonatal Outcomes (97866)

Niamh Hremiako 1 , Tessa Weir 1 2 3 4 , Sarah Glastras 1 2 4
  1. Northern Clinical School, The University of Sydney, Faculty of Medicine and Health, St Leonards, Sydney, NSW, Australia
  2. Department of Diabetes, Endocrinology & Metabolism, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia
  3. Nepean Hospital, Kingswood, NSW, Australia
  4. Kolling Institute , St Leonards, Sydney, NSW, Australia

Background and Aim: Obesity and type 1 diabetes (T1D) are both well-known independent risk factors for adverse maternal and neonatal outcomes. However, there is a paucity of research assessing their synergistic relationship in influencing perinatal outcomes. Hence, this study aimed to assess the impact of combined T1D and obesity on adverse maternal and neonatal outcomes.

Method: A retrospective cohort study was conducted of singleton births in the Northern Sydney Local Health District (2012-2022). Women with type 2 or gestational diabetes were excluded. 178 pregnancies to women with T1D and 44,281 to women without diabetes were analysed. Univariate analysis using chi-square test, and multivariate logistic regression were performed to analyse the effect of both T1D, obesity, and their interaction on pregnancy outcomes, including mode of delivery, hypertensive disorders, venous thromboembolism, stillbirth, pre-term birth, large-for-gestational-age (LGA), neonatal hypoglycaemia, respiratory distress, 5-minute APGAR scores, and neonatal intensive care unit admission.

Results: The mean body mass index (BMI) was higher for women with T1D than for women without diabetes (25.3±4.7 kg/m2 vs 23.5±4.2 kg/m2; P<0.001). Women with concomitant T1D and obesity were more likely to have LGA neonates (OR 14.28, CI 6.16-33.08; P<0.001), 5-minute APGAR scores <7 (OR 6.94, CI 2.04-23.58; P=0.002), and caesarean section delivery than women without diabetes and normal weight (OR 29.66, CI 6.91-127.36; P<0.001). Increasing BMI in women with T1D was associated with increased risk of developing pre-eclampsia (OR 13.15, CI 6.01-28.74; P<0.001).

Conclusion: This study provides compelling evidence that obesity in women with T1D significantly increases the risk of poorer perinatal outcomes. Moreover, the combined effect of T1D and obesity was greater than either condition alone. These findings underscore the importance of future research into identifying whether weight-management strategies in reproductive-aged women with obesity and T1D are effective in circumventing the poorer perinatal outcomes associated with these two conditions.

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