Maternal T1D Raises Odds of Adverse Neonatal Outcomes

TOPLINE:

In a nationwide study of over 1.4 million singleton births, neonates of mothers with type 1 diabetes (T1D) had substantially higher odds of stillbirth, congenital malformations, preterm birth, hypoglycaemia, and neonatal death.

METHODOLOGY:

• Researchers in Sweden conducted a nationwide cohort study of 1,402,394 singleton births to compare adverse neonatal outcomes between infants born to mothers with and without T1D.
• Data of neonates delivered at 22 or more completed gestational weeks between 2010 and 2022 were retrieved from the national birth register.
• Maternal T1D diagnoses and neonatal complications were ascertained from antenatal records and diagnostic codes.

TAKEAWAY:

• During the study period, 0.5% of women were diagnosed with T1D.
• Neonates born to mothers with T1D had higher odds of stillbirth (adjusted odds ratio [aOR], 2.54; 95% CI, 1.98-3.28) and congenital malformations (aOR, 1.66; 95% CI, 1.50-1.84).
• Women with T1D and underweight or obesity showed a significantly higher prevalence of congenital malformations than their normal-weight counterparts.
• Neonates of women with T1D were far more likely to born preterm (< 34 weeks of gestational age; aOR, 3.80), be large for gestational age (aOR, 22.0), develop hypoglycaemia (aOR, 45.85), and experience neonatal mortality (aOR, 4.1).

IN PRACTICE:

“Neonates born to mothers with type 1 diabetes faced higher risks compared to neonates born to mothers without type 1 diabetes, highlighting the need for a better understanding of the causation and how care can be improved for their mothers,” the authors wrote.

SOURCE:

This study was led by Alexandra Goldberg, Karolinska Institutet Soder Hospital, Stockholm, Sweden. It was published online on July 15, 2025, in Acta Paediatrica.

LIMITATIONS:

The authors were unable to account for all potential diabetic complications and maternal postprandial glucose levels before and during pregnancy. This study included only pregnancies that have completed 22 or more gestational weeks, which may have introduced selection bias. The authors could not control for elective or missed abortions attributable to congenital malformations.

DISCLOSURES:

This study did not receive any specific funding. The authors declared having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.