Poster Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2024

The role of overweight and obesity in explaining perinatal outcome differences between women with type 1 and type 2 diabetes (#267)

Praveena Raviraj 1 , Matilda Longfield 2 , Jackson Zhou 1 , Sarah Glastras 2
  1. The University of Sydney , Camperdown, NSW, Australia
  2. The Kolling Institute , Sydney , NSW , Australia

Background and Aims: Both diabetes and obesity are known risk factors for adverse perinatal outcomes. Few studies have compared outcomes among women with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) and none have examined the influence of concurrent overweight and obesity. Given the prevalence of obesity in T2DM and its rising prevalence in T1DM1, this study aims to assess the difference in perinatal outcomes between diabetes groups and examine whether BMI explains these differences. 

Methods: We retrospectively analysed data from all singleton births from mothers with either T1DM or T2DM within the Northern Sydney Local Health District from 2012-2022. Women were categorised by diabetes type, then grouped into non-overweight/obesity (BMI < 24.9) and overweight/obesity (BMI >25.0) classes. Outcomes assessed included gestational hypertension, pre-eclampsia, mode of delivery, prematurity, macrosomia, large and small for gestational age (LGA and SGA), neonatal hypoglycaemia and neonatal jaundice. Descriptive statistics using chi-square tests was performed, followed by multivariate regression to assess the combined impact of BMI and diabetes type. Statistical analysis was performed using SPSS.

Results: 291 women were included in the study, 177 with T1DM and 114 with T2DM. Gestational hypertension, birth weight, macrosomia, LGA and neonatal hypoglycaemia were all significantly higher in T1DM (p<0.05). SGA incidence was greater in T2DM (11.4% vs 1.7% in T1DM, p <0.001). Multivariate regression revealed maternal overweight and obesity increased the risk of neonatal jaundice independent of diabetes type. LGA risk was higher for women with overweight and obesity and concurrent T1DM, but not those with T2DM.

Conclusions: Perinatal outcomes are worse in pregnancies complicated by T1DM. Overweight and obesity has a greater influence on outcomes within the T1DM population. Weight management should be prioritised in all women of reproductive age, not solely those with T2DM, to best minimise the risk of adverse outcomes.

  1. Title: Overweight and obesity Australian Institute of Health and Welfare Institution: AIHW 2023 Canberra: DOI: https://www.aihw.gov.au/reports/overweight-obesity/overweight-and-obesity