Neonatal birth weight percentile following the use of sensor-augmented pump therapy in women with pre-gestational diabetes

Aims: To assess the effect of using sensor-augmented pump therapy (SAP) during pregnancy on neonatal birth weight percentile and other neonatal and pregnancy outcomes.

Methods: This retrospective cohort study included consecutive women with pregestational diabetes mellitus (PGDM) treated with an insulin pump and sensor that enabled the SAP feature during pregnancy. SAP use was defined as utilization of either low-glucose suspend (LGS) or predictive LGS technology. Utilization of SAP was according to physician discretion. Differences in neonatal birth weight percentile and in other neonatal and pregnancy outcomes were compared between those who did and not use SAP.

Outcomes: Of 142 women, 136 had type 1 diabetes, 5 type 2 diabetes and one diabetes due to pancreatectomy. 83 women used SAP and 59 did not. For the neonates of the mothers of the respective groups, the median birth weight percentiles were similar (79 and 80, pV = 0.96), as were the other neonatal outcomes assessed. The rate of cesarean section was higher in the SAP group. However, after adjusting for maternal age, BMI, and a history of severe hypoglycemic events before pregnancy, the relation between mode of delivery and the use of SAP was no longer statistically significant.

Conclusion: In women with PGDM treated with an insulin pump and sensor, SAP use during pregnancy was not associated with higher neonatal birth weight percentile or the occurrences of other adverse neonatal or pregnancy outcomes.