Gestational diabetes & diabetes in pregnancy
Fetal Overgrowth and Preterm Delivery in Women With Type 1 Diabetes Using Insulin Pumps or Multiple Daily Injections: A Post Hoc Analysis of the EVOLVE Study Cohort
Authors' conclusion
Insulin pump treatment in pregnant women with T1D, prior to the widespread use of continuous glucose monitoring or automated insulin delivery, was associated with a higher risk of LGA offspring and preterm delivery compared with MDI in crude and adjusted analyses. This association did not appear to be mediated by differences in glycemic control as represented by HbA1c or by gestational weight gain.
Study context
- Population
- Pregnant women with T1D enrolled from 17 countries, 2013–2018
- Participants
- 2,003 women
- Comparison
- Insulin pumps vs multiple daily injections (MDI)
- Pumpsn = 723
- MDIn = 1,280reference
- Primary endpoint
- Fetal overgrowth (large for gestational age (LGA) offspring) and preterm delivery
Methodological detailsreal-world setting, 17 countries
- Real-world setting
- 17 countries
Primary result
LGA offspring
Adjusted odds ratio
1.36
95% CI 1.09–1.70
P = 0.007
Between Pump and MDI
adjusted OR 1.36 (95% CI 1.09–1.70); P = 0.007
As reported in the abstract
Further findings
| Outcome | Adjusted OR (95% CI) | P value | |
|---|---|---|---|
| Preterm deliveryBetween Pump and MDI | 1.46 (1.17–1.82) | P < 0.001 | |
| 0.512Adjusted odds ratio (log scale) |
Preterm delivery
- Results did not change after adjustment for HbA1c or gestational weight gain
Original publication
Fetal Overgrowth and Preterm Delivery in Women With Type 1 Diabetes Using Insulin Pumps or Multiple Daily Injections: A Post Hoc Analysis of the EVOLVE Study Cohort. Diabetes Care. Published 21 December 2023. doi:10.
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