Overt diabetes imposes a comparable burden on outcomes as pregestational diabetes: a cohort study

Oppermann, Maria Lúcia; Campos, Maria Amélia; Hirakata, Vânia Naomi; Reichelt, Angela Jacob

doi:10.1186/s13098-022-00939-1

Diabetology & Metabolic Syndrome

Table 3 Third trimester glycated hemoglobin and pregnancy outcomes

From: Overt diabetes imposes a comparable burden on outcomes as pregestational diabetes: a cohort study

Outcome		HbA1c		p
	All	< 6.5%	≥ 6.5%
	n = 475 (100)	n = 282 (59)	n = 193 (41)
Maternal outcomes
Specialized appointments	8.0 [4.0–11.0]	8.0 [5.0–11.0]	6.0 [3.5–11.0]	< 0.001
Specialized appointments		282	193
Insulin use	415 (87.7)	234 (83.6)	181 (93.8)	0.001
Insulin use	473	280	193
Hospitalization due to DM	269 (59.0)	134 (49.8)	135 (72.2)	< 0.001
Hospitalization due to DM	456	269	187
Weight gain categories^b				< 0.001
less than recommended	169 (37.3)	122 (45.4)^a	47 (25.5)^a
as recommended	115 (25.4)	70 (26.0)^a	45 (24.5)^a
more than recommended	169 (37.3)	77 (28.6)^a	92 (50.0)^a
more than recommended	453	269	184
Initial HbA1c < 6.5%	154 (32.4)	131(46.5)	23 (11.9)	< 0.001
Initial HbA1c < 6.5%	475	282	193
HbA1c variation				0.060
unchanged	22 (4.6)	13 (4.6)^a	9 (4.7)^a
increased	89 (18.7)	43 (15.2)^a	46 (23.8)^a
decreased	364 (76.6)	226 (80.1)^a	138 (71.5)^a
decreased	475	282	193
Preeclampsia	143 (30.6)	83 (29.7)	60 (31.9)	0.692
Preeclampsia	467	279	188
Cesarean section	347 (75.8)	205 (75.6)	142 (75.9)	> 0.999
Cesarean section	458	271	187
Perinatal and neonatal outcomes
Pregnancy outcome				0.775
liveborn	446 (93.9)	264 (93.6)	182 (94.3)
stillborn	11 (2.3)	6 (2.1)	5 (2.6)
lost to follow-up	18 (3.8)	12 (4.3)	6 (3.1)
lost to follow-up	475	282	193
Preterm birth	90 (19.7)	45 (16.7)	45 (24.1)	0.069
Preterm birth	456	269	187
5 min Apgar < 7	17 (3.9)	9 (3.5)	8 (4.4)	0.808
5 min Apgar < 7	441	259	182
Birth weight (g)	3363 (723)	3281 (716)	3481 (718)	0.003
Birth weight (g)		269	187
Congenital anomaly	53 (11.9)	20 (11.0)	24 (13.3)	0.545
Congenital anomaly	445	264	181
Macrosomia	75 (16.5)	34 (12.6)	41 (21.9)	0.012
Macrosomia	456	269	187
Birth weight categories^c				0.002
LGA	173 (38.1)	84 (31.5)^a	89 (47.6)^a
AGA	261 (57.5)	168 (62.9)^a	93 (49.7)^a
SGA	20 (4.4)	15 (5.6)^a	5 (2.7)^a
SGA	454	267	187
Hypoglycemia	90 (20.4)	40 (15.4)	50 (27.6)	0.003
Hypoglycemia	441	260	181
Jaundice	148 (33.6)	73 (28.1)	75 (41.4)	0.005
Jaundice	441	260	181
Sepsis	76 (17.3)	31 (12.0)	45 (25.0)	0.001
Sepsis	439	259	180
Ventilatory disfunction	101 (23.0)	46 (17.8)	55 (30.6)	0.003
Ventilatory disfunction	439	259	180
NICU admission	169 (38.1)	80 (30.5)	89 (49.2)	< 0.001
NICU admission	443	262	181
Death^d	20 (4.4)	13 (4.8)	7 (3.7)	0.750
Death^d	457	270	187

Results presented as mean (standard deviation), n (%) or median (interquartile range)
HbA1c glycated hemoglobin, DM diabetes mellitus, LGA large for gestational age, AGA adequate for gestational age, SGA small for gestational age, NICU neonatal intensive care unit
Statistics: Student t test, the chi-square test (coupled with Z test for comparison of proportions, with Bonferroni correction when appropriate), and the Mann–Whitney U test
^aDenote differences between subgroups
^bAccording to the Institute of Medicine recommendation
^cAccording to the World Health Organization chart
^dIncludes perinatal and neonatal death

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ISSN: 1758-5996

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