Extended linkage of data to understand causes of serious adverse neonatal outcome in pregnancy complicated by pregestational diabetes in Scotland

In Scotland, pregnant women with type 1 (T1DM) or type 2 diabetes (T2DM) are at higher risk than women without diabetes of serious adverse outcomes.

They are 5x more likely to experience stillbirth, and have high rates of preterm delivery with 1 in 3 women with T1DM and 1 in 5 women with T2DM experiencing premature delivery. Causes of this are unknown. We know some premature deliveries will occur due to clinical decision-making for early delivery to prevent stillbirth.

There is no international consensus regarding timing of delivery in diabetes but women are often delivered earlier.

Using whole-population datasets we will define rates of stillbirth in T1DM and T2DM, and congenital diagnoses made in infants including causes of stillbirth.

We will define the risk of infants who were delivered at particular stages of pregnancy being diagnosed with a serious neonatal outcome or requiring intensive care, and describe the risk of stillbirth at each gestation.

We will examine maternal demographics including presence of diabetes complications and use of diabetes technology to better phenotype pregnancies at highest risk.

Seperately, we will define rates and identified causes of early pregnancy loss and terminations to help improve care for women.