Suboptimal Glycemic Control Ups The Risk of Having A Stillbirth in Diabetic Women

Saturday, May 10th 2003

• Tweet

Women with pregestational type 1 diabetes who experience stillbirths are more likely to have suboptimal glycemic control during pregnancy than their diabetic counterparts without a history of stillbirth. They are also more likely to have diabetic nephropathy, to smoke and to have low educational and social attainment.

That's according to an audit of 25 stillbirths experienced by 22 type 1 diabetic women, the results of which appear in the May issue of Diabetes Care. Three of the women had a history of two stillbirths.

Dr. Jeannet Lauenborg from National University Hospital Rigshospitalet in Copenhagen and a Danish team found a cause for seven stillbirths, namely chorioamnionitis, ketoacidosis, placental abruption, and severe intrauterine growth retardation.

They found a "likely" cause for stillbirth in six cases, namely severe malformations, multiple placental infarctions, and thrombosis in the umbilical cord.

There was no obvious explanation for the remaining 12 cases of stillbirth. However, in 9 of these 12 (67%) cases, glycemic control was suboptimal (HbA1c > 7.5%). Glycemic control in both early and late pregnancy was poorer in the stillbirth group when compared with a reference group consisting of 236 type 1 diabetic women without stillbirth.

Suboptimal glycemic control, the authors note, may "predispose to fetal distress, due to fetal hyperinsulinemia, acidosis, and hyperlacticemia, as maternal hyperglycemia and elevated HbA1c are risk factors for fetal asphyxia, possibly leading to intrauterine death."

The team also found that the incidence of diabetic nephropathy was six times higher in the stillbirth group than the reference group. Low educational level, high unemployment, and smoking also characterized the stillbirth group.

These findings, Dr. Lauenborg and colleagues conclude, highlight a group of diabetic women deserving "more attention" during pregnancy, especially with regards to optimizing their glycemic control.

Diabetes Care 2003;26:1385-1389
NEW YORK (Reuters Health) May 09 2003

 

If you need help or advice, you are welcome to email our naturopathic team with your health question.

Disclaimer: The health information presented here has been written for the New Zealand health consumer. It is of a general nature and is only intended to provide a summary of the subjects covered. The information is not intended to be comprehensive or to provide medical advice to you. While all care has been taken to ensure the accuracy of the information, no responsibility or liability is accepted, and no person should act in reliance on any statement contained in the information provided. All health ailments should be treated by a qualified health professional.

 

ref:n67

• Tweet