Endocrinol Diabetes Nutr (Engl Ed). 2026 Oct;73(8):501805. doi: 10.1016/j.endien.2026.501805.
ABSTRACT
BACKGROUND: With the global rise in diabetes mellitus (DM), pregnancies in women with preexisting DM are becoming increasingly common and are associated with a higher risk of adverse outcomes. However, the relative impact of type 1 diabetes mellitus (T1DM) vs type 2 diabetes mellitus (T2DM) remains unclear.
METHODS: This retrospective cohort study included pregnant women with preexisting DM followed between 2014 and 2024. Demographic, clinical, biochemical, and obstetric data were compared according to DM type. Primary outcomes included maternal complications, fetal growth, and neonatal morbidity.
RESULTS: Among 169 pregnancies, 114 (67.5%) involved T1DM and 55 (32.5%), T2DM. Compared with women with T2DM, those with T1DM were younger, had lower body mass index, longer diabetes duration, and a higher prevalence of diabetic retinopathy. They also had higher preconception HbA1c levels and greater gestational weight gain. T1DM was associated with higher odds of retinopathy progression, large-for-gestational-age neonates, and neonatal intensive care unit (NICU) admission, but lower odds of labor dystocia. Rates of miscarriage, preterm birth, hypertensive disorders of pregnancy, and cesarean delivery were similar between groups. Among women with T1DM, excessive gestational weight gain and higher late-pregnancy HbA1c levels were strongly associated with adverse neonatal outcomes.
CONCLUSIONS: Pregnancies complicated by T1DM showed a higher burden of adverse outcomes than those complicated by T2DM. Glycemic control and gestational weight gain emerged as key modifiable risk factors, underscoring the need for tailored management strategies.
PMID:42887928 | DOI:10.1016/j.endien.2026.501805