181-OR: Time in Range (TIR) Extrapolated from Self-Monitoring of Blood Glucose (SMBG) and Risk for Adverse Perinatal Outcomes in Pregnancies Complicated by T1DM

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Introduction and Objective: Type 1 diabetes mellitus (T1DM) is associated with increased risks of adverse pregnancy outcomes. While Continuous Glucose Monitoring Systems (CGMS) improve glycemic monitoring, self-monitoring of blood glucose (SMBG) remains the primary method for most pregnant women due to accessibility and cost barriers. This study aimed to evaluate the association between time-in-range (TIR) extrapolated from SMBG and adverse perinatal outcomes in T1DM pregnancies.Methods: A retrospective cohort study included singleton pregnancies with live births and no malformations, starting prenatal care before 20 weeks (2010-2019). Glycemic data were categorized into TIR (63-140 mg/dL), time below range (TBR), and time above range (TAR) and stratified as TIR <50%, 50-70%, and >70%. Logistic regression analyzed independent predictors of adverse outcomes, including prematurity, LGA, and neonatal respiratory distress.Results: Among 140 participants that provided 142,997 capillary blood measurements, 20% had TIR <50%, 53.6% had TIR 50-70%, and 26.4% had TIR >70%. Higher TIR was inversely associated with adverse outcomes. Compared to TIR <50%, TIR 50-70% and TIR>70% were associated with lower risks of prematurity (OR 0.271, 95%CI 0.094-0.786; OR 0.219, 95%CI 0.058-0.826), neonatal respiratory distress (OR 0.341, 95%CI 0.124-0.936; OR 0.122, 95%CI 0.029-0.516), and LGA (OR 0.246, 95%CI 0.084-0.719; OR 0.115, 95%CI 0.028-0.469).Conclusion: Achieving glucose targets during pregnancy is particularly challenging for women with T1DM. Nonetheless, this study demonstrates that even modest achievements such as >50% TIR, extrapolated from SMBG, significantly reduces the risks of prematurity, LGA, and neonatal respiratory distress. These findings highlight the importance of supporting pregnant women with T1DM in achieving individualized glycemic goals to optimize maternal and neonatal outcomes.

Disclosure

E.A.M. Santos: None. T. Assuncao Zaccara: None. F.C.F. Mikami: None. M.D. Bernardi: None. C. de Freitas Paganoti: None. R.P.V. Francisco: None. R.A. Costa: None.



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