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Pregnancy Outcomes in Young Women With Youth-Onset Type 2 Diabetes Followed in the TODAY Study

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posted on 08.12.2021, 20:05 by Jeanie B. Tryggestad, Megan M. Kelsey, Kimberly L. Drews, Steven D. Chernausek, Elia N. Escaname, Elvira Isganaitis, Sarah Macleish, Siripoom McKay, Jennifer Sprague, Steve Willi, the TODAY Study Group
Objective: To assess pregnancy outcomes in young women with youth-onset type 2 diabetes followed in the TODAY study.

Research Design and Methods: Pregnancy information (outcome, any maternal or fetal complications) was obtained from the female participants by self-report. Additionally, medical records for the pregnancy and the child’s neonatal course were obtained with data abstracted into standardized forms.

Results: Over a maximum of 15 years, 260 pregnancies were reported by 141 women (age 21.5 years ± 3.2 years, BMI 35.6 ± 7.2 kg/m2, diabetes duration 8.1 ± 3.2 years). Contraception use prior to pregnancy reported by 13.5% of the women. Complications were reported by 65% of the women during their pregnancy. Pregnancy loss was observed in 25.3% and preterm birth in 32.6% of pregnancies. HbA1c ≥ 8% was observed in 31.9% of the pregnancies and 35% of the pregnancies were complicated by chronic hypertension. Nephropathy prior to pregnancy was observed in 25% of the women. In the offspring, 7.8% were classified as small for gestational age, 26.8% large for gestational age, and 17.9% in the macrosomic range.

Conclusion: Based on observations from the TODAY cohort, young women with pre-gestational, youth-onset type 2 diabetes had very high rates of maternal complications stemming from significant socioeconomic disadvantage. The substantial maternal and infant complications seen in these young moms could potentially be avoided with improved contraception rates and reproductive planning.


This work was completed with funding from NIDDK and the NIH Office of the Director through grants U01-DK61212, U01-DK61230, U01-DK61239, U01-DK61242, and U01-DK61254. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The NIDDK project office was involved in all aspects of the study, including: design and conduct; collection, management, analysis, and interpretation of the data; review and approval of the manuscript; and decision to submit the manuscript for publication.