Gestational diabetes & diabetes in pregnancy
Congenital malformations among offspring of women with type 1 diabetes who use insulin pumps: a prospective cohort study
Authors' conclusion
Insulin pump treatment was not associated with a lower risk of congenital malformations, despite better glycaemic control in early pregnancy compared with MDI. Further studies exploring the efficacy and safety of pump treatment during pregnancy are needed.
Study context
- Population
- Pregnant women with T1D in a real-world setting
- Participants
- 2,088 women
- Comparison
- Insulin pump vs MDI
- Pumpn = 750
- MDIn = 1,338reference
- Primary endpoint
- Offspring with congenital malformations or perinatal or neonatal death
Methodological detailsreal-world setting, propensity score-matched
- Real-world setting
- Propensity score-matched
Primary result
As reported in the abstract
Fetuses with at least one malformation
Each group vs MDIEstimate (95% CI)P value
Pump
crude OR 1.23(0.94–1.61)
P = 0.13Pump
propensity score-matched (adjusted) OR 1.11(0.81–1.52)
P = 0.52Further findings
| Outcome | Pump | MDI | Estimate | P value | |
|---|---|---|---|---|---|
| Fetuses with at least one major malformation | 2.8% | 3.1% | crude OR 0.89 (95% CI 0.52–1.51) | P = 0.66 | |
| Fetuses with at least one major malformation | adjusted OR 0.78 (95% CI 0.42–1.45) | P = 0.43 | |||
| Fetuses with ≥1 minor malformation (no major malformations) | 10.7% | 8.1% | crude OR 1.36 (95% CI 1.00–1.84) | P = 0.05 | |
| Fetuses with ≥1 minor malformation (no major malformations) | adjusted OR 1.23 (95% CI 0.87–1.75) | P = 0.25 | |||
| Perinatal death | 1.6% | 1.3% | crude OR 1.23 (95% CI 0.57–2.67) | P = 0.59 | |
| Perinatal death | adjusted OR 2.02 (95% CI 0.69–5.93) | P = 0.20 | |||
| 0.20.5125Ratio (log scale) |
Neonatal death
P = not applicable
HbA1c below 75 mmol/mol (9%) at enrolment
P < 0.001
Folic acid supplementation reported
P < 0.001
University degree
P < 0.001
HbA1c at enrolment · enrolment (gestational week 8; 95% CI 4, 14)
P < 0.001
- HbA1c at enrolment: 6.8±0.9% vs 7.1±1.3%
- HbA1c at enrolment: HbA1c remained lower in pump users after propensity score matching
Original publication
Congenital malformations among offspring of women with type 1 diabetes who use insulin pumps: a prospective cohort study. Diabetologia. Published 14 January 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →