Impact of early diagnosis of overt diabetes on pregnancy outcomes: a retrospective cohort study among Brazilian women.

OBJECTIVE

Early diagnosis of overt diabetes has not been extensively explored. We compared pregnancy outcomes of women diagnosed with overt diabetes in the first trimester (up to the 13 completed weeks) to those with a later diagnosis.

SUBJECTS AND

METHODS

We evaluated women with overt diabetes and a type 2 diabetes phenotype. Pregnancy evolution (gestational weight gain, HbA1c, inpatient glycemic control) and outcomes (preeclampsia, neonatal hypoglycemia, and admission to the neonatal intensive care unit) were compared using multivariable analyses (linear regression or Poisson regression with robust variances). All models computed the early diagnosis and other specific clinically relevant outcome-related variables. Results are b (linear coefficient) or adjusted relative risk (RR) with 95% CI.

RESULTS

Of the 217 study participants, 127 (58.5%) were diagnosed in the first trimester (early diagnosis group); those with a late diagnosis presented a higher 3rd-trimester HbA1c (n = 169; b = 1.29; 0.04; 0.55, p = 0.026). Maternal inpatient care was associated with later diagnosis (n = 195; RR 1.29; 1.02; 1.63, p = 0.033) and higher initial HbA1c (n = 195; RR 1.25; 1.16; 1.35, p < 0.001). Aside from a better maternal metabolic control, early diagnosis of overt diabetes did not impact any other pregnancy outcome.

CONCLUSIONS

In the present cohort of women with overt diabetes, diagnosis before the 14 gestational week modestly improved a few maternal metabolic aspects that did not translate into better pregnancy outcomes.