Diabetes Care. 2024 Aug 7:dc240725. doi: 10.2337/dc24-0725. Online ahead of print.
ABSTRACT
OBJECTIVE: The increased risk of pregnancy complications in type 1 diabetes is mainly attributed to maternal hyperglycemia. However, it is unclear whether other potentially modifiable factors also contribute to risk in this population. We sought to assess whether high BMI and excessive gestational weight gain (GWG) are associated with perinatal complications in type 1 diabetes.
RESEARCH DESIGN AND METHODS: We searched Medline, Embase, PubMed, Scopus, Web of Science, and Cochrane databases to January 2024. Studies examining associations between periconception BMI or GWG and perinatal complications in type 1 diabetes were included. We used a predesigned data extraction template to extract study data including year, country, sample size, participants’ characteristics, exposure, and outcomes. We included 29 studies (18,965 pregnancies; 1978-2019) in the meta-analysis.
RESULTS: A 1 kg/m2/1 kg increase in preconception BMI or GWG was associated with a 3% and 11% increase, respectively, in perinatal complications (BMI odds ratio [OR] 1.03 [95% CI 1.01-1.06]; GWG OR 1.11 [95% CI 1.04-1.18]). Preconception BMI ≥ 25 kg/m2 or excessive GWG was associated with a 22% and 50% increase, respectively, in perinatal complications (BMI OR 1.22 [95% CI 1.11-1.34]; GWG OR 1.50 [95% CI 1.31-1.73]). BMI was associated with congenital malformation, preeclampsia, and neonatal intensive care unit admission. Excessive GWG was associated with preeclampsia, cesarean delivery, large for gestational age, and macrosomia.
CONCLUSIONS: Addressing maternal BMI prepregnancy and preventing excessive GWG should be key clinical priorities to improve outcomes in pregnant women with type 1 diabetes.
PMID:39110568 | DOI:10.2337/dc24-0725
