BJOG : an international journal of obstetrics and gynaecology · 2026
Temporal Trends in Pregnancy Outcomes Among Parents With Type 1 Diabetes: A Nationwide Register-Based Study.
СтатьяНазвание и аннотация: Перевод в очереди
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Gundersen Tina Wullum, Knorr Sine, Ringholm Lene, Moeller Jensen Dorte, Damm Peter, Kragelund Nielsen Karoline, Backman Helena, Lauenborg Jeannet, Mathiesen Elisabeth Reinhardt, Petersen Anne Helby, Skipper Niels, Kofoed-Enevoldsen Allan, Clausen Tine Dalsgaard
Аннотация
OBJECTIVE: To assess temporal trends in outcomes of pregnancies with maternal or paternal type 1 diabetes compared to the general population.
DESIGN: Register-based study.
SETTING: Denmark.
POPULATION: 1 551 893 pregnancies from 1997 to 2021, hereof 5478 with maternal and 8072 with paternal type 1 diabetes.
METHODS: Crude and adjusted logistic regression analyses allowing for interaction between diabetes and time compared outcomes of pregnancies with maternal or paternal type 1 diabetes to the general population and evaluated temporal trends over a 25-year period.
MAIN OUTCOME MEASURES: Hypertensive disorders of pregnancy, caesarean delivery, preterm delivery (< 37-week gestation), very preterm delivery (< 34-week gestation), large for gestational age (LGA) (birth weight > 90th percentile) and extreme LGA (birth weight > 97.5th percentile).
RESULTS: We observed an increasing prevalence of maternal (0.3%-0.4%) and paternal (0.5%-0.6%) diabetes during the study period. From 1997-2001 to 2017-2021, pregnancies with maternal diabetes had decreasing odds of preterm delivery (aOR 0.62, 95% CI 0.51;0.74), very preterm delivery (aOR 0.62, 95% CI 0.44;0.87) and extreme LGA (aOR 0.73, 95% CI 0.61;0.88) but remained associated with higher odds of each considered pregnancy outcome in both first and last period (aOR 3.59-18.86) compared to the general population. Pregnancies exposed to paternal diabetes were comparable to the general population.
CONCLUSIONS: Despite a decline in adverse outcomes in pregnancies with maternal type 1 diabetes over the last 25 years, the odds remain greatly increased. These findings support a predominant role of maternal diabetes management rather than parental diabetes genes for pregnancy outcomes.
DESIGN: Register-based study.
SETTING: Denmark.
POPULATION: 1 551 893 pregnancies from 1997 to 2021, hereof 5478 with maternal and 8072 with paternal type 1 diabetes.
METHODS: Crude and adjusted logistic regression analyses allowing for interaction between diabetes and time compared outcomes of pregnancies with maternal or paternal type 1 diabetes to the general population and evaluated temporal trends over a 25-year period.
MAIN OUTCOME MEASURES: Hypertensive disorders of pregnancy, caesarean delivery, preterm delivery (< 37-week gestation), very preterm delivery (< 34-week gestation), large for gestational age (LGA) (birth weight > 90th percentile) and extreme LGA (birth weight > 97.5th percentile).
RESULTS: We observed an increasing prevalence of maternal (0.3%-0.4%) and paternal (0.5%-0.6%) diabetes during the study period. From 1997-2001 to 2017-2021, pregnancies with maternal diabetes had decreasing odds of preterm delivery (aOR 0.62, 95% CI 0.51;0.74), very preterm delivery (aOR 0.62, 95% CI 0.44;0.87) and extreme LGA (aOR 0.73, 95% CI 0.61;0.88) but remained associated with higher odds of each considered pregnancy outcome in both first and last period (aOR 3.59-18.86) compared to the general population. Pregnancies exposed to paternal diabetes were comparable to the general population.
CONCLUSIONS: Despite a decline in adverse outcomes in pregnancies with maternal type 1 diabetes over the last 25 years, the odds remain greatly increased. These findings support a predominant role of maternal diabetes management rather than parental diabetes genes for pregnancy outcomes.