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Q&A

Diabetes

Poster Session 3

(827) Outcomes of Adolescent Pregnancies with Diabetes

Wednesday, February 14, 2024

8:30 AM – 10:00 AM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Michael Richley, MD

Department of OB/GYN
University of Washington
Seattle, WA, United States

Coauthor(s)

Christina S. Han, MD (she/her/hers)

Associate Clinical Professor
David Geffen School of Medicine at UCLA
Los Angeles, CA, United States
LW

Lauren E. Wisk, PhD

Assistant Professor Division of General Internal Medicine & Health Services Research
David Geffen School of Medicine, University of California Los Angeles
Los Angeles, CA, United States
TM

Tannaz Moin, MBA, MD

Associate Professor, Division of Endocrinology, Diabetes, and Metabolism
David Geffen School of Medicine, University of California Los Angeles
Los Angeles, CA, United States
TC

Timothy Copeland, PhD

Fielding School of Public Health at UCLA
Los Angeles, CA, United States
EE

Estelle Everett, MD

Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine
David Geffen School of Medicine, University of California Los Angeles
Los Angeles, CA, United States

Objective: National trends in obesity and metabolic syndrome have resulted in increasing rates of diabetes (DM) in pregnancy. These trends in pregestational comorbidities also affect the teenage populations. However, the potential additive effect of DM and adolescent status on pregnancy risks remains poorly elucidated. We sought to evaluate rates of adverse outcomes from adolescent pregnancies (AP) with DM.

Study Design: We performed a retrospective cohort study using the Kids’ Inpatient Database (KID) to identify pediatric admissions (≤20 years old) with ICD codes pertaining to Labor and Delivery and diabetes during five periods in the past decade (2006, 2009, 2012, 2016, 2019) in the United States. We used appropriate bivariate (e.g., chi-square) and multivariate (e.g., logistic regression) statistics to evaluate differences in obstetrics outcomes by diabetes status.

Results: We identified 1,823,854 AP without DM, 3327 AP with type 1 (T1) DM, 3050 AP with type 2 (T2) DM, and 12,909 with gestational DM (GDM). Table 1 shows rates of outcomes by DM type. Compared to AP without diabetes, preterm delivery (T1: OR 4.53, 95% CI 4.09-50.2; T2: OR 3.35, 95% CI 2.96-3.78: GDM: 1.18, 95% CI 1.08-1.28), hypertensive disorders of pregnancy (T1: OR 4.32, 95% CI 3.95-4.74; T2: OR 4.18, 95% CI 3.79-4.61; GDM: OR 1.99, 95% CI 1.89-2.10), and cesarean delivery increased for all types of DM (p< 0.001 for all). Length of stay and cost of admission were also increased for any DM diagnosis (p< 0.001). Fetal anomaly rates remained unchanged for GDM, but increased for T1 and T2 DM (p< 0.001).

Conclusion: Diabetes in pregnancy potentiates the risks associated with adolescent pregnancies. This data highlights the need for targeted public health interventions to counteract both the rates of teen pregnancies and the epidemic of metabolic dysfunction in adolescent populations with rising rates of both T2DM and GDM. Public health and nutrition programs are needed to address the intersection of these epidemics.