EP02.01: Maternal glucose control and fetal growth trajectories in type 1 diabetes

To assess the impact of glucose control on fetal growth patterns in pregnant women with Type 1 diabetes. In this prospective longitudinal study, 95 pregnant women with Type 1 diabetes underwent serial ultrasound biometry in 4-6 weeks intervals from 16 weeks. Glucose monitoring with a sensor was initiated before pregnancy or during the first trimester. The data obtained from sensors — including mean glycemia, TIR (time spent in target [3.5–7.8 mmol/l]), TBR (time spent below target), TAR (time spent above target), coefficient of glucose variation (CV) – and glycated hemoglobin (A1c) were analysed for every trimester. Maternal characteristics and relevant variables associated with diabetes and fetal growth were recorded. Latent class analysis was used to identify subgroups of fetuses with similar growth trajectories. Subsequently, maternal glucose control was compared between the groups. Three subgroups with different growth patterns were identified. Compared to other clusters with accelerated growth peaking between 25 to 30 weeks of gestation, cluster 1 showed constant AC growth during pregnancy (see figure 1). Women in cluster 1 had lower mean glycemia and TAR but higher TBR in the second trimester (p = 0.018, p = 0.024, p = 0.042, respectively) and lower mean A1c in the second and third trimesters (p = 0.018; p = 0.016), compared to other clusters. The prevalence of large-for-gestation-age newborns was 6.8%, 41.7%, and 78.4% in clusters 1, 2, and 3, respectively (p< 0.001). Other factors, including age, BMI, and duration of diabetes, were unrelated to the fetal growth pattern. Maternal glucose control in the second and third trimesters contributes to determining fetal growth trajectory and birthweight in women with type 1 diabetes. NU20-01-00067. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.