Diabetes
Poster Session 1
Subeen Hong, MD
Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea
.jpg "Kyung A Lee, MD, PhD photo")
Kyung A Lee, MD, PhD
College of Medicine, Ewha Womans University
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Young Mi Jung, MD (she/her/hers)
Korea University College of Medicine, Seoul, Republic of Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Won Young Wi, BS
Korea University College of Medicine, Seoul, Republic of Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Ji-Hee Sung, MD, PhD
Samsung Medical Center, Sungkyunkwan University School of Medicine
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Hyun-Joo Seol, MD, PhD
Kyung Hee University School of Medicine
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Won Joon Seong, MD, PhD
School of Medicine, Kyungpook National University
Kyongsang-bukto, Kyongsang-bukto, Republic of Korea
.jpg "Soo Ran Choi, MD, PhD photo")
Soo Ran Choi, MD, PhD
Inha University Hospital
Incheon, Republic of Korea
Joon Ho Lee, MD, PhD
Yonsei University Health System, Yonsei University College of Medicine
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Seung Cheol Kim, MD, PhD
Biomedical Research Institute, Pusan National University College of Medicine
Pusan, Pusan-jikhalsi, Republic of Korea
Sae-Kyoung Choi, MD, PhD
Obstetrics and gynecology
Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Seoul, Inch'on-jikhalsi, Republic of Korea
Ji Young Kwon, MD, PhD
Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea
.jpg "Hyun Soo Park, MD, PhD photo")
Hyun Soo Park, MD, PhD
Professor
Graduate School of Medicine, Dongguk University
Goyang, Kyonggi-do, Republic of Korea
Hyun Sun Ko, MD, PhD
Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea
The aim of our study is to evaluate both the overall and organ-specific teratogenic risk in pregnant women with overt diabetes mellitus based on their pre-pregnancy fasting blood sugar (FBS) levels.
Study Design: In this a national population-based retrospective cohort study, we included women diagnosed with diabetes before pregnancy who underwent health examinations and had FBS measurements within one year before conception. The participants were grouped based on FBS levels into well-controlled (FBS < 100 mg/dL), less-controlled (FBS: 100-125 mg/dL), and poorly-controlled (FBS ≥ 126 mg/dL) groups. Additionally, the well-controlled group was further subdivided into four subgroups based on FBS levels (table). Using the reference group, the relative risk of overall fetal malformations and organ-specific malformations was calculated for the other groups using multivariable analysis.
Results: A total of 5,687 women were included in this study. The well-controlled group had a 10% overall rate of fetal malformations, while the less controlled group had a 13.6% overall rate, and the poorly controlled group had an 18.6% overall rate of fetal malformations (p< 0.001). In the subgroups with FBS levels < 100 mg/dL, there was no significant increase in the overall or organ-specific teratogenic risk compared to the reference group. However, the overall teratogenic risk was 1.3 times higher in the less controlled group and 1.8 times higher in the poorly controlled group than in the reference group (table). Specifically, the risk of cardiac malformations was 2.5 times higher, and the risk of skeletal malformations was 3.3 times higher than reference group.
Conclusion: Our national population-based study demonstrates that when FBS levels are ≥ 100 mg/dL during the pre-conceptional period in women with pre-gestational diabetes, there is an elevated risk of fetal malformations, particularly concerning cardiac and skeletal malformations. However, some changes of FBS within 100 mg/dL during the pre-conceptional period may not increase the teratogenic risk during pregnancy (grant number: HC23C0124).