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• W4283786122 abstract "Information regarding the postpartum period in women with type 1 diabetes (T1D) is scarce. We aim to evaluate the relation of impaired hypoglycaemia awareness (IAH) in early pregnancy and breastfeeding status (its presence and duration) with severe postpartum hypoglycaemia (SH).Retrospective cohort study of women with T1D followed during pregnancy between 2012 and 2019. Data on SH were recorded before and during pregnancy. IAH was evaluated at the first antenatal visit. Data on breastfeeding and the long-term postpartum period were collected by questionnaire and from medical records.A total of 89 women with T1D were included with a median follow-up after pregnancy of 19.2 [8.7–30.5] months. Twenty-eight (32%) women had IAH at the first antenatal visit. At discharge, 74 (83%) started breastfeeding during a median of 8 [4.4–15] months. A total of 18 (22%) women experienced ≥1 SH during postpartum. The incidence of SH significantly increased from pregestational to the gestational and post-partum period (0.09, 0.15 and 0.25 episodes/patient-year, respectively). Postpartum SH rates were comparable in breastfeeding and non-breastfeeding women (21.4% vs. 25%, respectively, p > 0.05). Clarke test score at the first antenatal visit was associated with postpartum SH (for each 1-point increase: OR 1.53; 95% CI, 1.06–2.21) adjusted for confounders. No other diabetes and pregnancy-related variables were identified as predictors of SH in this period.SH are common in the long-term postpartum period independently of breastfeeding. Assessing IAH in early pregnancy could identify those at an increased risk of SH in the postpartum period.Hay pocos datos sobre el periodo posparto en mujeres con diabetes tipo 1. Nuestro objetivo fue evaluar la relación entre la percepción alterada de las hipoglucemias (PAH) al inicio de la gestación y la lactancia (modalidad y duración) con las hipoglucemias graves (HG) posparto.Estudio retrospectivo de cohortes de mujeres con diabetes tipo 1 seguidas durante la gestación durante 2012-2019. Se recogieron las HG antes y durante la gestación. Se evaluó la PAH en la primera visita obstétrica. Los datos sobre lactancia y el periodo posparto se recogieron mediante cuestionario y de la historia clínica.Se incluyeron 89 mujeres con diabetes tipo 1 con un seguimiento posparto de 19,2 (8,7-30,5) meses. Veintiocho (32%) tenían PAH en la primera visita obstétrica. Al alta, 74 (83%) iniciaron lactancia materna durante una mediana de 8 (4,4-15) meses. Dieciocho (22%) mujeres tuvieron ≥ 1 HG en el posparto. La incidencia de HG aumentó significativamente del periodo pregestacional a la gestación y el posparto (0,09, 0,15 y 0,25 episodios/paciente-año, respectivamente). La tasa de HG posparto fue comparable en mujeres con lactancia materna y artificial (21,4 vs. 25%, respectivamente, p > 0,05). La puntuación en el test de Clarke en la primera visita obstétrica se asoció independientemente a HG posparto (por incremento de un punto: OR 153; IC 95% 1,06-2,21). No se identificaron otros predictores de HG entre las variables relacionadas con la diabetes o la gestación durante este periodo.Las HG son frecuentes en el largo plazo posparto, independientemente del modo de lactancia. Evaluar la PAH al inicio de la gestación podría identificar aquellas mujeres con un mayor riesgo de HG en el posparto." @default.
• W4283786122 created "2022-07-04" @default.
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• W4283786122 date "2023-06-01" @default.
• W4283786122 modified "2023-09-24" @default.
• W4283786122 title "Tumores testiculares de restos adrenales en la enfermedad de Addison" @default.
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• W4283786122 doi "https://doi.org/10.1016/j.endinu.2022.03.006" @default.
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