Abstract
Objective
Our aim in this study was to compare the effects of risk factors for large-for-gestational-age
(LGA) birthweight between women with type 1 and type 2 diabetes mellitus (TIDM and
T2DM, respectively).
Methods
A retrospective cohort study was conducted for women with T1DM (n=152) and T2DM (n=255)
attending a diabetes/pregnancy clinic during the period from 2009 to 2016. Multiple
logistic regression analysis was used to identify variables associated with LGA birthweight.
Results
LGA was significantly higher in those with T1DM (39%) than T2DM (17%) (p<0.001). Among
those with T1DM, there was a nonsignificant association between LGA and continuous
subcutaneous insulin infusion (odds ratio, 1.17; 95% confidence interval, 0.99 to
1.39; p=0.06) and excess maternal weight gain (T1DM odds ratio, 1.19; 95% confidence
interval, 0.99 to 1.43; p=0.069). In those with T2DM, there was an association between
LGA and glycated hemoglobin at delivery (T2DM odds ratio, 1.10; 95% confidence interval,
1.02 to 1.19; p=0.01).
Conclusions
In the study population, glycemic control at delivery was predictive of LGA in women
with T2DM, and there was a trend toward an association of maternal weight gain and
continuous subcutaneous insulin infusion with LGA infants in T1DM. Further study is
warranted to better guide targeted interventions to reduce high rates of LGA birthweight
in T1DM/T2DM.
RÉSUMÉ
Objectif
Notre objectif dans cette étude était de comparer les effets des facteurs de risque
pour le poids à la naissance lors d'une macrosomie fœtale (MF) entre les femmes atteintes
de diabète sucré de type 1 et de type 2 (DST1 et DST2, respectivement).
Méthodes
Une étude de cohorte rétrospective a été menée auprès de femmes atteintes de DST1
(n=152) et de DST2 (n=255) qui ont fréquenté une clinique du diabète/de grossesse
entre 2009 et 2016. Une analyse de régression logistique multinomiale a été utilisée
pour identifier les variables associées au poids à la naissance de la MF.
Résultats
La MF était significativement plus élevée pour les femmes atteintes de DST1 (39%)
que chez celles atteintes du DST2 (17%) (p<0.001). Chez celles atteintes du DST1,
une association non significative a été observée entre la MF et la perfusion sous-cutanée
continue d'insuline (rapport de cotes, 1.17; intervalle de confiance à 95%, 0.99 à
1.39; p=0.06) et le gain de poids excessif chez la mère (rapport de cotes DST1, 1.19;
intervalle de confiance à 95%, 0.99 à 1.43; p=0.069). Chez les femmes atteintes de
DST2, il y avait une association entre la MF et l'hémoglobine glyquée à l'accouchement
(rapport de cotes pour le DST2, 1.10; intervalle de confiance à 95%, 1.02 à 1.19;
p=0.01).
Conclusions
Dans la population de l'étude, le contrôle glycémique à l'accouchement était prédictif
de la MF chez les femmes atteintes de DST2, et une tendance a été observée vers une
association du gain de poids maternel et de la perfusion sous-cutanée continue d'insuline
avec la MF infantile en cas de DST1. Une autre étude demeure nécessaire pour mieux
orienter les interventions ciblées visant à réduire les taux élevés de poids à la
naissance lors de MF dans les cas de DST1/DST2.
Keywords
Mots clés
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Article info
Publication history
Published online: September 04, 2019
Accepted:
August 19,
2019
Received in revised form:
July 30,
2019
Received:
March 14,
2019
Identification
Copyright
© 2019 Canadian Diabetes Association.
