Background

We aimed to report the pregnancy outcomes of women with type 1 diabetes (T1D) in China, on which data was sparse.

Methods

This is a nationwide retrospective study conducted in 11 general medical centers in eight cities across China. We investigated the clinical data of all women who attended these centers with a singleton pregnancy and whose pregnancy ended between January 1st, 2004, and December 31st, 2014. Pregnancies of women with pregestational T1D were ascertained and compared with those of women without T1D.

Results

From over 300,000 pregnancies over the 11-year study period, we identified 265 singleton pregnancies of women with T1D. One out of 265 (0.37%) maternal death was documented among women with T1D, and 83 out of 318,486 (0.03%) in those without T1D. Women with T1D suffered from higher rates of pregnancy loss(13.21% vs 2.92%, crude risk ratio [cRR] 5.08, 95% confidence interval [CI] 3.56–7.26) and pre-eclampsia(17.74% vs 4.20%, cRR 4.94, 95% CI 3.60–6.77) compared with those without T1D. Infants of these women with T1D had elevated rates of neonatal death(5.65% vs 0.16%, cRR 37.36, 95% CI 21.21–65.82) and congenital malformation(s)(8.26% vs 3.53%, cRR 2.46, 95% CI 1.54–3.93), compared with those of women without T1D. No significant improvement in pregnancy outcomes in women with T1D was observed over 2004–2014.

Conclusion

Pregnancy outcomes were persistently poor in women with T1D during 2004–2014 in China. Pregnancy care needs improving to reduce adverse pregnancy outcomes among Chinese women with T1D.