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Objective: To determine whether inter-pregnancy weight loss is associated with improved perinatal outcomes among pregnancies complicated by recurrent diabetes. Methods: We performed a retrospective cohort study of all women with at least 2 singleton pregnancies complicated by gestational (GDM) or type 2 (T2DM) and cared for by the Resident Diabetes in Pregnancy Clinic at a large tertiary referral center from 2007-2017. Women whose initial pregnancy weight decreased between pregnancies were compared to those whose weight stayed the same or increased. Demographic characteristics were compared between groups and logistic regression was used to control for potential confounding variables including maternal age, race, and depression. Results: There were 62 pregnancies complicated by recurrent diabetes during the study period. Weight loss between pregnancies occurred in 24 women. Women with pregnancies with inter-pregnancy weight loss were older (31.6 vs. 27.6, p=0.01) and had higher early pregnancy Edinburgh Postnatal Depression Scale scores (median 7; IQR 5,8 vs. median 2; IQR 1, 3, =0.01). Adjusted analyses using logistic regression demonstrated no significant association between inter-pregnancy weight loss and adverse maternal/neonatal outcomes including large for gestational age, small for gestational age, cesarean section, shoulder dystocia, birth injury, NICU admission>24 hours, and preterm birth. Conclusions: Inter-pregnancy weight loss was not associated with improved maternal or neonatal outcomes among pregnancies complicated by GDM or T2DM. Future studies are needed to identify the impact of depression on gestational weight gain/loss and subsequent pregnancy outcomes. Disclosure L. Yu: None. C.J. Herrick: None. H.E. Duckham: None. E.B. Carter: None. Funding American Diabetes Association/Pathway to Stop Diabetes (1-19-ACE-02 to E.B.C.); Robert Wood Johnson Foundation (74250); Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD095075)

Objective: To determine whether women living in highly deprived neighborhoods, defined by Area Deprivation Index (ADI), have worse glycemic control than those in less deprived areas. Methods: We performed a retrospective cohort study of low-income, previously uninsured pregnant women with T2DM from 2007-2017. We compared women living in high (≥ top quartile) or middle (middle quartiles) ADI neighborhoods to those living in low (≤bottom quartile) ADI neighborhoods. Demographic characteristics were compared and trends in mean A1c throughout pregnancy were tested with repeated measures analysis. Results: Of 367 women meeting study criteria (ADI range 1-10; IQR 7-10), 81 lived in low, 181 in middle, and 105 in high ADI neighborhoods. Demographics were similar between groups, except the high ADI group had more Black women and more severe diabetes by White Class. All groups achieved significant improvement in HgbA1c; however, the high ADI group was unable to achieve the same level of glycemic control by the third trimester after controlling for race and disease severity. There were no differences in pregnancy outcomes. Conclusion: Intensive prenatal care was insufficient to overcome neighborhood deprivation with regard to glycemic control; thus, additional neighborhood level interventions are likely needed to overcome this inequality. Disclosure L. Zahedi-Spung: None. B.E. Polnaszek: None. H.E. Duckham: None. C.J. Herrick: None. E.B. Carter: None. Funding American Diabetes Association/Pathway to Stop Diabetes (1-19-ACE-02 to E.B.C.); Robert Wood Johnson Foundation (74250); Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD095075)