Alexandra Goldberg

Aim: This register‐based study aimed to investigate differences in adverse neonatal outcomes between neonates born to mothers with and without type 1 diabetes in Sweden. Methods: A nationwide cohort study was conducted using the Swedish Medical Birth Register, including all singleton births from 22 gestational weeks between 2010 and 2022. The neonatal outcomes among neonates of women with and without type 1 diabetes were studied with descriptive statistics and logistic regressions. Adjusted odds ratios (aORs) with 95% confidence intervals are presented. Results: The study consisted of 1 402 394 neonates, and 0.5% had a mother with type 1 diabetes. Neonates of mothers with type 1 diabetes had increased odds of stillbirth ( aOR 2.54; 95% CI 1.98–3.28), congenital malformations ( aOR 1.66; 95% CI 1.50–1.84), preterm birth ( aOR 3.80; 95% CI 3.41–4.23), large for gestational age ( aOR 22.0; 95% CI 20.9–23.1), hypoglycaemia ( aOR 45.85; 95% CI 43.60–48.22), and neonatal death ( aOR 4.1; 95% CI 3.00–5.83). Conclusion: Neonates of mothers with type 1 diabetes continue to experience poorer neonatal outcomes, highlighting the need for more research on the causes and how care can be improved for their mothers during pregnancy.

Background: Supplementary feeding, colostrum or, in some countries, commercial milk formula, is given to newborns of women with Type 1 diabetes to prevent neonatal hypoglycemia. Few studies have explored the content of colostrum from women with Type 1 diabetes. Research Aims: This study aimed to investigate the macronutrients in colostrum collected during pregnancy and in the early postpartum period to compare colostrum contents in women with and without Type 1 diabetes. Methods: In this cohort study, we collected colostrum among 20 women, 10 with and 10 without Type 1 diabetes, at 10 different time points in gestational weeks 36–40 and postpartum Days 1–5. We measured carbohydrates, protein, fat, and kilocalories in colostrum using a human milk analyzer; and we analyzed data using linear mixed models. In a follow-up analysis, we compared the content of colostrum from Day 1 with the nutritional values provided on the commercial milk formula, using a one-sample t test. Results: There were no mean differences in carbohydrates (6.6 g/100 ml; 95% CI [6.3, 6.9] vs. 6.7 g/100 ml; 95% CI [6.4, 7.0] p = 0.29); kilocalories (71.1 kcal/100 ml; 95% CI [62.9, 79.3] vs. 85.3 kcal/100 ml; 95% CI [77.2, 93.3] p = 0.21], and fat (2.7 g/100 ml; 95% CI [1.8, 3.6] vs. 2.3 g/100 ml; 95% CI [1.4, 3.2] p = 0.55) in colostrum when comparing women with and without Type 1 diabetes. However, antenatal protein differed at all timepoints tested ( p = 0.01). Colostrum macronutrients on Day 1 differed from that of commercial milk formula and all other colostrum time points, except Gestational Week 38. Conclusions: Our study provides insights into antenatal and postnatal colostrum macronutrients among women with and without Type 1 diabetes. Further studies are needed to understand the effects of supplementary feeding using antenatal or postnatal colostrum or commercial milk formula on neonatal hypoglycemia.