Work

Maternal and neonatal outcomes in patients with type 1 diabetes mellitus in pregnancy in a South African cohort

Year: 2025

Type: article

Abstract: BACKGROUND: Women with type 1 diabetes mellitus (T1DM) are at high risk of maternal, pregnancy and neonatal complications. Limited data on this topic are available in Africa. OBJECTIVE: To describe characteristics of patients in South Africa with T1DM in pregnancy, and associated outcomes. METHODS: Clinical and biochemical data were collected on 273 women with T1DM: maternal clinical characteristics, glycated haemoglobin (HbA1c) and maternal and neonatal complications and outcomes. RESULTS: There was a statistically significant decline in HbA1c from first presentation to delivery (8.7% (standard deviation (SD) 2.2) v. 6.4% (SD 2.4)), respectively; p<0.00001). The perinatal mortality rate was 7.2%. In this cohort, 31.9% of patients experienced hypoglycaemia. Patients with hypoglycaemia had a significantly longer duration of diabetes, and higher HbA1C than those without hypoglycaemia (7.5 (SD 5.7) v. 6.1 (SD 4.5) years, p=0.002; 9.0% (SD 1.9) v. 8.5% (SD 2.3), p=0.04, respectively)). CONCLUSION: This cohort showed a high perinatal mortality rate and a high prevalence of hypoglycaemia and caesarean section. Intensification in glycaemic control is important to improve outcomes, but comes with challenges. A significant HbA1C reduction can be achieved with regular follow-up and management with a multidisciplinary team. Despite poor baseline glycaemic control, the prevalence of congenital abnormalities and macrosomia was low.

Source: South African Medical Journal

DOI: 10.7196/samj.2025.v115i11.2592

Authors: G Yudelowitz, N Goolam Mahyoodeen

Institutions: University of the Witwatersrand, Chris Hani Baragwanath Hospital

Language: English

Topic: Gestational Diabetes Research and Management

Subfield: Obstetrics and Gynecology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $311