Open AccessEffects of Peri-Conception and Pregnancy Glycemic Variability on Pregnancy and Perinatal Complications in Type 1 Diabetes: A Pilot Study
Author(s) -
Riëlle Hoek-Hogchem,
Sarah A. Bovenberg,
Pim Dekker,
Erwin Birnie,
Henk J. Veeze,
Hans Duvekot,
Sander Galjaard,
HenkJan Aanstoot
Publication year - 2022
Publication title -
experimental and clinical endocrinology and diabetes
Language(s) - English
Resource type - Journals
eISSN - 1439-3646
pISSN - 0947-7349
DOI - 10.1055/a-1797-8317
Subject(s) - medicine , pregnancy , complication , glycemic , obstetrics , odds ratio , logistic regression , diabetes mellitus , endocrinology , genetics , biology
Background: Not much is known about the effects of glycemic variability (GV) during the pre- and periconception period on pregnancy/perinatal complications. GV could potentially contribute to identification of high-risk pregnancies in women with type 1 diabetes.Methods: An explorative retrospective cohort study was conducted between January 2014 and May 2019. Glucose data were retrieved from electronic patient charts. Pre-/periconceptional GV and GV during all three trimesters was expressed as mean glucose, standard deviation (SD), Coefficient of Variation (CV), High Blood Glucose Index (HBGI), Low Blood Glucose Index (LBGI) and Average Daily Risk Range (ADRR). Maternal and neonatal complications were summarized using a composite total complication score. Binary logistic regression analyses were conducted to assess correlations between the GV measures and a total complication score >3, a maternal complication score >1 and a neonatal complication score >1.Results: Of 63 eligible women, 29 women (38 pregnancies) were included. Women in the group with a total complication score >3 had a significantly higher ADRR at conception (OR 1.1, CI 1.0–1.2, p=0.048). No statistically significant correlation between complication score and any other GV metric besides the ADRR were found. Although not significant, in the group with a complication score >3, odds ratios >1 were found for SD in trimester 1 (OR 1.6, CI 0.6–4.5, p=0.357) and trimester 2 (OR 1.8, CI 0.5–6.2, p=0.376). Conclusions: Presence of a positive association between GV and pregnancy and perinatal complications depends on which pregnancy period is assessed and the GV metrics that are used.