Maternal Type 1 Diabetes Elevates Neonatal Risks Significantly

Nationwide Study Reveals Stark Differences in Birth Outcomes

New research indicates that infants born to mothers with type 1 diabetes (T1D) face considerably higher risks of stillbirth, birth defects, premature birth, low blood sugar, and death shortly after birth.

Swedish Study Uncovers Adverse Neonatal Outcomes

A comprehensive nationwide study in Sweden tracked over 1.4 million singleton births, comparing outcomes for newborns of mothers with and without type 1 diabetes. The data, spanning from 2010 to 2022, focused on infants born at 22 weeks gestation or later, drawing information from national birth registers and antenatal records.

Key Findings Detail Increased Risks

The study found that 0.5% of mothers included in the analysis had a diagnosis of type 1 diabetes. These neonates demonstrated significantly elevated odds of stillbirth (adjusted odds ratio [aOR], 2.54) and congenital malformations (aOR, 1.66). Mothers with T1D and pre-pregnancy underweight or obesity experienced a higher frequency of birth defects compared to normal-weight mothers with T1D.

Severe Complications Highlighted for T1D Pregnancies

Infants born to mothers with T1D were substantially more likely to be born extremely preterm (before 34 weeks gestation), as indicated by an aOR of 3.80. Furthermore, these newborns had a staggering 22-fold increased likelihood of being large for their gestational age (aOR, 22.0), a 45-fold increased risk of developing hypoglycemia (aOR, 45.85), and a fourfold higher chance of neonatal mortality (aOR, 4.1).

Expert Commentary Emphasizes Need for Improved Care

“Neonates born to mothers with type 1 diabetes faced higher risks compared to neonates born to mothers without type 1 diabetes, highlighting the need for a better understanding of the causation and how care can be improved for their mothers,” the authors wrote.

—Alexandra Goldberg, Karolinska Institutet Soder Hospital, Stockholm, Sweden

Study Limitations Acknowledge Data Gaps

The researchers noted limitations, including the inability to account for all diabetic complications or specific maternal glucose levels throughout pregnancy. The exclusion of pregnancies ending before 22 weeks might also have introduced selection bias, and the study could not control for elective or missed abortions linked to congenital abnormalities.

The findings underscore the critical importance of meticulous prenatal care and management for pregnant individuals with type 1 diabetes. For instance, in the United States, managing gestational diabetes, a condition with similarities in blood sugar control, involves careful monitoring and dietary adjustments to reduce risks, as highlighted by the CDC.