AIMS/HYPOTHESIS The aim of this study was to describe the characteristics and outcomes of pregnancies in a national cohort of teenage (<20 years) and young adult women (≥20 years) with and without childhood-onset (<15 years) type 1 diabetes. We hypothesised that, owing to poor glycaemic control during the teenage years, pregnancy outcomes would be poorer in teenage mothers with type 1 diabetes than young adult mothers with type 1 diabetes and mothers without diabetes. METHODS The Brecon Register of childhood-onset type 1 diabetes diagnosed in Wales since 1995 was linked to population-based datasets in the Secure Anonymised Information Linkage (SAIL) Databank, creating an electronic cohort (e-cohort) of legal births (live or stillbirths beyond 24 weeks' gestation) to women aged less than 35 years between 1995 and 2013 in Wales. Teenage pregnancy rates were calculated based on the number of females in the same birth cohort in Wales. Pregnancy outcomes, including pre-eclampsia, preterm birth, low birthweight, macrosomia, congenital malformations, stillbirths and hospital admissions during the first year of life, were obtained from electronic records for the whole Welsh population. We used logistic and negative binomial regression to compare outcomes among teenage and young adult mothers with and without type 1 diabetes. RESULTS A total of 197,796 births were eligible for inclusion, including 330 to girls and women with childhood-onset type 1 diabetes, of whom 68 were teenagers (age 14-19 years, mean 17.9 years) and 262 were young adults (age 20-32 years, mean 24.0 years). The mean duration of diabetes was 14.3 years (9.7 years for teenagers; 15.5 years for young adults). Pregnancy rates were lower in teenagers with type 1 diabetes than in teenagers without diabetes (mean annual teenage pregnancy rate between 1999 and 2013: 8.6 vs 18.0 per 1000 teenage girls, respectively; p < 0.001). In the background population, teenage pregnancy was associated with deprivation (p < 0.001), but this was not the case for individuals with type 1 diabetes (p = 0.85). Glycaemic control was poor in teenage and young adult mothers with type 1 diabetes (mean HbA1c based on closest value to conception: 81.3 and 80.2 mmol/mol [9.6% and 9.5%], respectively, p = 0.78). Glycaemic control improved during pregnancy in both groups but to a greater degree in young adults, who had significantly better glycaemic control than teenagers by the third trimester (mean HbA1c: 54.0 vs 67.4 mmol/mol [7.1% vs 8.3%], p = 0.01). All adverse outcomes were more common among mothers with type 1 diabetes than mothers without diabetes. Among those with type 1 diabetes, hospital admissions during the first year of life were more common among babies of teenage vs young adult mothers (adjusted OR 5.91 [95% CI 2.63, 13.25]). Other outcomes were no worse among teenage mothers with type 1 diabetes than among young adult mothers with diabetes. CONCLUSIONS/INTERPRETATION Teenage girls with childhood-onset type 1 diabetes in Wales are less likely to have children than teenage girls without diabetes. Teenage pregnancy in girls with type 1 diabetes, unlike in the background population, is not associated with social deprivation. In our cohort, glycaemic control was poor in both teenage and young adult mothers with type 1 diabetes. Pregnancy outcomes were comparable between teenage and young adult mothers with type 1 diabetes, but hospital admissions during the first year of life were five times more common among babies of teenage mothers with type 1 diabetes than those of young adult mothers with diabetes.

中文翻译：

---

在儿童期诊断为1型糖尿病的青少年中进行的妊娠：一项基于全国人群的电子队列研究。

目的/假设本研究的目的是描述全国性青少年（<20岁）和年轻成年女性（≥20岁）有和没有儿童期发病（<15岁）1型人群的妊娠特征和预后。糖尿病。我们假设，由于青少年时期的血糖控制不佳，患有1型糖尿病的少女母亲的妊娠结局要比患有1型糖尿病的成年母亲和没有糖尿病的母亲的妊娠结局更差。方法自1995年以来，在威尔士诊断出的1型糖尿病儿童布雷肯病登记册与安全匿名信息链接（SAIL）数据库中基于人群的数据集建立了联系，从而建立了合法出生（活产或死产）的电子队列（e队列） 1995年至2013年间在威尔士居住的年龄小于35岁的女性）。根据威尔士同一出生队列中的女性人数，计算出少女怀孕率。从整个威尔士人群的电子记录中可以获取妊娠结局，包括先兆子痫，早产，低出生体重，巨大儿，先天性畸形，死产和住院第一年的住院记录。我们使用逻辑和二项式负回归来比较患有和不患有1型糖尿病的青少年和成年母亲的结局。结果共有197,796例婴儿符合入选条件，其中330例患有儿童型1型糖尿病的女孩和妇女，其中68例是青少年（14-19岁，平均17.9岁），而262例是年轻人（20岁至20岁）。 32年，平均24.0年）。糖尿病的平均持续时间为14.3年（青少年为9.7年；年轻人为15.5年）。1型糖尿病青少年的怀孕率低于无糖尿病青少年（1999年至2013年的年平均怀孕率：分别为每千名少女8.6比18.0； p <0.001）。在背景人群中，少女怀孕与剥夺有关（p <0.001），但对于1型糖尿病患者则不是这种情况（p = 0.85）。患有1型糖尿病的少女和成年母亲的血糖控制很差（根据与怀孕最接近的值，平均HbA1c：分别为81.3和80.2 mmol / mol [9.6％和9.5％]，p = 0.78）。两组孕妇在怀孕期间的血糖控制均得到改善，但在青壮年中，青壮年的血糖控制水平明显高于青少年（平均HbA1c：54.0 vs 67.4 mmol / mol [7.1％vs 8.3％]，p = 0.01） ）。与1型糖尿病母亲相比，所有不良后果在1型糖尿病母亲中更为常见。在患有1型糖尿病的人中，青少年和年轻成年母亲的婴儿在出生后第一年的住院治疗更为普遍（校正后的OR为5.91 [95％CI 2.63，13.25]）。在患有1型糖尿病的少女母亲中，其他结果也没有在患有糖尿病的年轻成年母亲中更糟。结论/解释威尔士患有儿童期1型糖尿病的少女比未患糖尿病的少女更容易生育。与背景人群不同，患有1型糖尿病的女孩的少女怀孕与社会剥夺无关。在我们的队列中，患有1型糖尿病的青少年和成年母亲的血糖控制都很差。