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Contemporary type 1 diabetes pregnancy outcomes: impact of obesity and glycaemic control

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The known  Type 1 diabetes in pregnant women is associated with complications for both mother and baby. Optimal glycaemic control reduces the likelihood of these adverse outcomes.

The new  The mean body mass index of Australian women with type 1 diabetes is greater than that of women without diabetes. Even with multidisciplinary specialist care and good glycaemic control, their likelihood of adverse outcomes was greater than for women without diabetes because of this additional risk factor.

  The implicationsPre-conception care is important, but optimising glycaemic control is not sufficient to prevent complications associated with type 1 diabetes during pregnancy. Preventing obesity in childbearing women with type 1 diabetes requires greater attention.

Type 1 diabetes accounts for 5–10% of diabetes diagnoses, and is a well recognised and important risk factor for a number of complications during pregnancy.1 Women with type 1 diabetes have a higher risk of miscarriage, hypertensive complications and obstetric interventions, and their babies have an increased risk of congenital malformations, stillbirth, macrosomia and birth trauma.2

In 1989, the St Vincent Declaration…