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Maternal-fetal outcomes of pregnant women with type 1 diabetes treated with continuous subcutaneous insulin infusion or multiple daily injections during pregnancy - A Brazilian health care referral center cohort study
Ogassavara, Juliana; Dualib, Patricia Medici; Mattar, Rosiane; Dib, Sérgio Atala; Almeida-Pititto, Bianca de.
  • Ogassavara, Juliana; Universidade Federal de São Paulo. Programa de Pós-graduação em Endocrinologia e Metabologia. São Paulo. BR
  • Dualib, Patricia Medici; Universidade Federal de São Paulo. Departamento de Medicina. São Paulo. BR
  • Mattar, Rosiane; Universidade Federal de São Paulo. Departamento de Obstetrícia. São Paulo. BR
  • Dib, Sérgio Atala; Universidade Federal de São Paulo. Programa de Pós-graduação em Endocrinologia e Metabologia. São Paulo. BR
  • Almeida-Pititto, Bianca de; Universidade Federal de São Paulo. Programa de Pós-graduação em Endocrinologia e Metabologia. São Paulo. BR
Arch. endocrinol. metab. (Online) ; 67(6): e220483, Mar.-Apr. 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1447280
ABSTRACT
ABSTRACT Objective: Pregnant women with type 1 diabetes (T1D) have an increased risk of maternal-fetal complications. Regarding treatment, continuous subcutaneous insulin infusion (CSII) has advantages compared to multiple daily injections (MDI), but data about the best option during pregnancy are limited. This study's aim was to compare maternal-fetal outcomes among T1D patients treated with CSII or MDI during pregnancy. Subjects and methods: This study evaluated 174 pregnancies of T1D patients. Variables of interest were compared between the groups (CSII versus MDI), and logistic regression analysis was performed (p < 0.05). Results: Of the 174 included pregnancies, CSII was used in 21.3% (37) and MDI were used in 78.7% (137). HbA1c values improved throughout gestation in both groups, with no difference in the first and third trimesters. The frequency of cesarean section was significantly higher in the CSII group [94.1 vs. 75.4%, p = 0.017], but there was no significant difference in the frequency of other complications, such as miscarriage, premature delivery and preeclampsia. The mean birth weight and occurrence of neonatal complications were also similar, except for the proportion of congenital malformations, which was significantly lower in the CSII group [2.9 vs. 15.6%, p = 0.048]. In regression analysis, the association of CSII with cesarean section and malformations lost significance after adjusting for HbA1c and other covariates of interest. Conclusion: In this study, we observed a higher frequency of cesarean section and a lower occurrence of congenital malformations in the CSII group, but the adjusted results might indicate that these associations are influenced by glycemic control.


Texto completo: DisponíveL Índice: LILACS (Américas) Tipo de estudo: Estudo de etiologia / Estudo observacional / Fatores de risco País/Região como assunto: América do Sul / Brasil Idioma: Inglês Revista: Arch. endocrinol. metab. (Online) Assunto da revista: Endocrinologia / Metabolismo Ano de publicação: 2023 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Universidade Federal de São Paulo/BR

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Texto completo: DisponíveL Índice: LILACS (Américas) Tipo de estudo: Estudo de etiologia / Estudo observacional / Fatores de risco País/Região como assunto: América do Sul / Brasil Idioma: Inglês Revista: Arch. endocrinol. metab. (Online) Assunto da revista: Endocrinologia / Metabolismo Ano de publicação: 2023 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Universidade Federal de São Paulo/BR