Diabetes and up-to-date pregnancy risks
12th January 2018 – The number of pregnant women with type 1 or type 2 diabetes has increased and a new Scottish study has found the condition continues to raise the possibility of complications.
Researchers and clinicians from Scottish institutes and hospitals found that both types of diabetes are associated with stillbirths, emergency Caesarean sections, premature babies, and an increased risk of perinatal mortality - deaths just before and shortly after birth.
The researchers studied 15 years of data covering all pregnancies in Scotland between 1 April 1998 and 31 March 2013.
In that time there were 813,921 deliveries and just 38 were excluded due to unavailable data on the baby.
Within the group of new mothers 4,681 had pre-existing diabetes, of whom 3,229 had type 1 and the remaining 1,452 had type 2.
The large-scale study has been published in Diabetologia - the journal of the European Association for the Study of Diabetes.
It was already known that pregnancies were made more complicated by pre-existing type 1 or type 2 diabetes but the researchers wanted up-to-date information to see if things had improved in Scotland.
What they found was, compared to Scottish women without diabetes:
- Stillbirths were 4 times higher in women with type 1 diabetes and 5 times higher in women with type 2 diabetes.
- Perinatal deaths were 3.1 times higher in women with type 1 diabetes and 4.2 times higher in women with type 2 diabetes.
- More than half of all babies born to mothers with type 1 diabetes were large for their gestational age, 4.8 times higher than the wider population. This is becoming more common.
- Over a third of mothers with type 2 diabetes had a baby who was large for its gestational age which increases the risk of complications during pregnancy. This is 3.7 times higher than the wider population.
- Caesareans, either emergency or elective, occur more often in mothers with diabetes with two thirds of women with type 1 diabetes and 60% with type 2 diabetes undergoing operative delivery. This compares to 24% of other mothers.
- Mothers with diabetes were more likely to give birth prematurely, with 35.3% of those with type 1 diabetes and 21.8% of those with type 2 having a preterm birth, whereas women without diabetes had a 6.1% chance of giving birth early.
The researchers say pregnancy for women with diabetes remains high risk.
Kathryn Kirchner, clinical advisor at Diabetes UK, told us via email: "Sadly this research has highlighted that despite advances in diabetes care, there's still a long way to go in improving outcomes for pregnant women with diabetes.
"We know that managing diabetes during pregnancy can be challenging, but there are a number of things women can do to minimise the risks to themselves and their baby. These include thorough pre-conception care, having recommended checks, and keeping their blood glucose levels controlled before, during and after their baby is born.
"This highlights the importance of good diabetes care and support before, during and after pregnancy."
She says if you are concerned about the study findings, contact your diabetes specialist or call the Diabetes UK helpline.