Helen R. Murphy, United Kingdom

University of East Anglia Norwich Medical School
Helen Murphy, MB BCh BAO, FRACP, MD, Clinical Professor, Dept. of Medicine; University of East Anglia (UK) Helen Murphy is a Professor of Medicine (Diabetes and Antenatal Care) at the University of East Anglia and Professor of Women’s Health at Kings College London. She is also an honorary consultant physician at Cambridge University NHS Foundation Trust and at Norfolk & Norwich University Hospital NHS Trust. She runs a diabetes pregnancy research programme which aims to improve the glucose control and infant health outcomes of pregnant women with diabetes. Her research interests include pregnancy planning and improving access to prepregnancy care, continuous glucose monitoring and closed-loop/artificial pancreas technologies. Her research is funded by Juvenile Diabetes Research Foundation (JDRF), Diabetes UK, Diabetes Research & Wellness Foundation (DRWF), and the National Institute for Health Research (NIHR).

Presenter of 3 Presentations

PARALLEL SESSION

Introduction

INDUSTRY SESSION

Updates and Trends in Guidelines and Clinical Practice with Pregnant Women with Diabetes:  A UK Perspective

PARALLEL SESSION

Pregnancy outcomes of 17,375 women with diabetes: National population-based cohort study

Abstract

Abstract Body

Background: Our aim was to compare risk factors associated with adverse pregnancy outcomes in women with type 1 and type 2 diabetes.

Methods: We included 17,375 pregnancies in 15,290 women with diabetes in a population-based cohort study across 172 maternity clinics. Obstetric complications (preterm delivery, large birthweight) and adverse pregnancy outcomes (congenital anomaly, stillbirth, neonatal death) were obtained for pregnancies during 2014-2018. We assessed associations between modifiable (glycaemia, obesity, clinic) and non-modifiable risk factors (age, deprivation, ethnicity) with pregnancy outcomes.

Results: Of 17,375 pregnancies, 8,690 (50.0%) were in women with type 1 and 8,685 (50.0%) in women with type 2 diabetes. The rates of preterm delivery (42.5% type 1, 23.4% type 2), and large birthweight (52.2% type 1, 26.2% type 2) were higher in type 1 diabetes (p<0.001). The prevalence of congenital anomaly (44.8/1000 type 1, 40.5/1000 type 2; p=0.175), and stillbirth (10.4/1000 type 1, 13.5/1000 type 2; p=0.072) did not differ but neonatal death rates (7.4/1000 type 1, 11.2/1000 type 2; p=0.013) were higher in type 2 diabetes. Independent risk factors for perinatal death were third trimester HbA1c > 48mmol/mol (OR 3.06, 95% CI 2.16 to 4.33), living in the highest deprivation quintile (OR 2.29 95% CI 1.16 to 4.52) and having type 2 diabetes (OR 1.65 95% CI 1.18 to 2.31). Variations in glycaemia and large birthweight were associated with maternal characteristics (diabetes duration, deprivation, BMI) without substantial differences between clinics.

Interpretation: No clinics were achieving appreciably better outcomes, suggesting that healthcare system changes are needed across all clinics.

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Moderator of 1 Session

PARALLEL SESSION
Date
Wed, 02.06.2021
Session Type
PARALLEL SESSION
Session Time
20:10 - 21:40
Room
Hall C