Study Provides Insight Into Pregnancy Problems and Their Prevention in Women With Diabetes
What to Know
Women with diabetes have an elevated risk of serious problems during pregnancy, including miscarriages, stillbirths, and birth defects. After facing these risks once, many women fear similar problems during future pregnancies. However, it’s unclear if the risks remain—or increase—during their second pregnancy. Researchers set out to answer that question.
Researchers evaluated the health records of 220 English women with type 1 or type 2 diabetes. Each had gone through two pregnancies between 1996 and 2008. They examined how each woman prepared for pregnancy (for example, by controlling blood glucose levels) and tallied any problems, such as birth defects, stillbirths, and infant deaths, that occurred during the pregnancy. Finally, they sought to determine if these factors affected the risks the women faced during their second pregnancy.
During their first pregnancies, 30.5% of the women had serious complications, including birth defects, stillbirths, and infant deaths. During their second pregnancies, that percentage dropped by nearly half to 16.8%. However, the women who had problems during their first pregnancy were twice as likely to have problems in their second compared to women whose first pregnancies proceeded without incident. Most of the women did not prepare for their pregnancies by adequately controlling their blood glucose or taking recommended supplements.
Women who had no problems in their first pregnancy appear even less likely to have problems in their second. However, previous difficulties do predict a high risk of future complications. Women with diabetes need support from their caregivers to prepare for pregnancy. It’s not clear if the risks apply equally to women with type 1 and type 2 diabetes. Also, there were not enough women to break down the results by ethnic group or by disease complications, such as kidney disease. Finally, some medical records were lacking for some women, which could have affected the results.
Risk and recurrence of serious adverse outcomes in the first and second pregnancies of women with preexisting diabetes, by TPeter W.G. Tennant and colleagues. Diabetes Care 2015;38:610–619 https://doi.org/10.2337/dc14-1888