Diabetes During Pregnancy can be Tough on Baby

Diabetes in pregnancy increased congenital anomaly and perinatal mortality risk

(RxWiki News) Diabetes rates are rising, and so are the rates of pregnant women with diabetes. Improper care and poor monitoring of the condition could have health consequences for both mom and baby.

A recent study found that the rate of gestational diabetes (diabetes that develops during pregnancy) and pre-gestational diabetes (diabetes prior to pregnancy) doubled in the last 14 years.

The researchers reported that the risks for physical birth defects, fetal death and newborn death were significantly higher in women with gestational or pre-gestational diabetes than in women who did not have diabetes.

"Get your blood sugar under control if you're planning on getting pregnant."

The lead author of this study was Denice S. Feig, MD, from the Department of Medicine at the University of Toronto and the Division of Endocrinology and Metabolism at Mount Sinai Hospital — both in Toronto, Ontario, Canada.

The study included 1,109,605 women aged 15 to 50 years old who gave birth in Ontario, Canada between April 1, 1996 and March 31, 2010.

A total of 45,384 of the women developed diabetes while pregnant (gestational diabetes), 13,278 of the women had diabetes prior to pregnancy (pre-gestational diabetes), and 1,050,943 of the women did not have diabetes at all.

The average age of the women with gestational and pre-gestational diabetes was 32 years old, and the average age of the women with no diabetes was 30 years old.

The researchers used the Canadian Institute for Health Information Discharge Abstract Database to obtain hospitalization dates and medical records, and used the Ontario Diabetes Database to identify cases of diabetes.

Newborns were followed up to one year.

Congenital anomalies are physical defects that happen at birth; the researchers considered cases that affected the baby's heart, spine, central nervous system, stomach and kidneys.

Perinatal mortality was defined as intrauterine stillbirth (when the fetus dies in the uterus) or postnatal newborn death (baby dies after being born). Miscarriages were not included.

The findings showed that the gestational diabetes rate increased from 3 percent to 6 percent and the pre-gestational diabetes rate increased from 1 percent to 2 percent from 1996 to 2010.

The women aged 30 years and older had higher rates of gestational and pre-gestational diabetes in both 1996 and 2010 compared to the women ages 15 to 29 years old.

In addition, the women with gestational and pre-gestational diabetes were more likely to be older, in a lower socioeconomic group and have more doctor visits.

Compared to the women with no diabetes, those with gestational and pre-gestational diabetes were more at risk for having babies with congenital anomalies.

The rate of physical birth defects was 62 out of 1,000 births in the pre-gestational group, 38 out of 1,000 births in the gestational group and 29 out of 1,000 births for the women with no diabetes.

The researchers found that the rate of physical birth defects fell by 23 percent in women with pre-gestational diabetes and by 20 percent in women with gestational diabetes.

Compared to the women without diabetes, those with pre-gestational diabetes and gestational diabetes had an 86 percent and 26 percent increased risk of having a baby with physical birth defects.

The findings revealed the rate of perinatal mortality did not change significantly during the study period.

However, the women with pre-gestational diabetes were 2.33 times more likely to have perinatal mortality compared to women without diabetes in 2010.

The women with gestational diabetes had a 37 percent decreased risk for perinatal mortality.

The authors mentioned a few limitations of their study. First, the data did not differentiate between women with type 1 diabetes and type 2 diabetesSecond, the researchers did not have data on factors such as blood sugar control, obesity and ethnicity.

This study was published on April 4 in Diabetes Care.

The Canadian Diabetes Association and the Institute for Clinical Evaluative Sciences provided funding.

Review Date: 
April 11, 2014