(348) Comparing perinatal outcomes in gestational and cystic fibrosis related diabetes

Thursday, January 30, 2025

10:30 AM – 12:30 PM

Presenting Author(s)

Briana Clifton, BA (she/her/hers)

Medical Student
University of Minnesota Medical School
Falcon Heights, Minnesota, United States

Coauthor(s)

BO

Basra Osman, BA

Medical Student
University of Minnesota Medical School
Fridley, Minnesota, United States
KT

Katelyn M. Tessier, BS, MS

Senior Biostatistician
University of Minnesota
Minneapolis, Minnesota, United States
AM

Amir Moheet, MBBS

University of Minnesota
Minneapolis, Minnesota, United States

Submitting Author(s)

Sarah A. Wernimont, MD, PhD

Assistant Professor
University of Minnesota
Minneapolis, MN, United States

Objective: Gestational Diabetes (GDM) and pre-existing cystic fibrosis-related diabetes (CFRD) impact 18-62% of pregnancies in individuals with cystic fibrosis (CF). While GDM and CFRD can alter maternal metabolism and contribute to hyperglycemia, it is unknown if there are specific differences in clinical outcomes related to GDM compared to CFRD.

Study Design: This is a retrospective cohort study from 2011-2023 of all singleton, non-anomalous pregnancies affected by cystic fibrosis within a multi-institution health system obstetric outcome database. Individuals with CFRD were diagnosed prior to pregnancy, and GDM was diagnosed by glucose tolerance testing during the second or third trimester in those without evidence of CFRD before pregnancy. Metabolic, pregnancy, and neonatal outcomes between individuals with CFRD and GDM were statistically compared using Wilcoxon rank-sum tests or Fisher’s exact test as indicated.

Results: 31 individuals with CF were identified: 16 with CFRD, 6 with GDM, and 9 without diabetes. While no one with GDM required insulin, those with CFRD used 15 units (range 5.9, 31.9) of insulin daily in the third trimester, with an average increase of 0.5 units from pre-pregnancy dosing. As expected, those with CFRD had higher median hemoglobin A1c (HbA1c) compared to those with GDM during preconception (6.3 vs. 5.3, p=0.005), 3rd trimester (6.0 vs. 5.1, p=0.033), as well as postpartum (6.2 vs. 5.7, p=0.047). HbA1c decreased 0.4% for GDM and 0.7% for CFRD throughout gestation. No differences in pregnancy-induced hypertensive disorders or gestational age at birth were observed. Additionally, there were no significant differences in median birth weights, rates of large for gestational-age neonates, or neonatal hypoglycemia.

Conclusion:

We find that individuals with CFRD have higher insulin needs and HbA1c than those with GDM though both groups have similar maternal and neonatal outcomes.