Diabetic pregnancy complications stable since 1980s

By Anne Harding

NEW YORK (Reuters Health) - Despite changes during the 1990s in how pregnant women with diabetes are treated, no significant reduction in the risk of complications for these women and their newborns has occurred, according to a new study from Nova Scotia.

The findings make it clear that it is crucial for women with diabetes to get their blood glucose under control if they are even thinking about pregnancy, Dr. Elizabeth A. Cummings of the Izaak Walton Killam Health Centre in Halifax told Reuters Health.

Cummings pointed out that high blood sugar levels can affect organ formation, which occurs when the fetus is between six and eight weeks old -- before many women even know they're pregnant.

"They need to seek help and seek help early to do what they can to make sure they can have a healthy baby," she added.

Results of a large study published in 1996 showed that tight control of blood sugar could dramatically reduce the risk of pregnancy complications among diabetic women, including the risk of miscarriage and birth defects. New forms of insulin and other tools have been introduced that make it somewhat easier for people with diabetes to control and monitor their blood sugar.

Nevertheless, notes Cummings, "it's not an easy task at any point...it's a lot of hard work."

To investigate whether changes in medical knowledge, as well as the 1995 opening of a special clinic in the province for pregnant women with diabetes, had improved pregnancy outcomes, Cummings and her team compared data on pregnancy outcomes for women in the province for 1989-1995 and 1996-2002.

The study included 516 infants born to mothers with diabetes and 150,589 infants born to mothers without diabetes.

The rates of infant death, birth defects, prematurity and infants born large for their gestational age were all significantly higher - about three times higher -- in women with diabetes than in those without diabetes. However, there were no significant differences in the rates of these complications over time among the women with diabetes.

However, it's important to note, Cummings added, that the majority of the infants born to the diabetic women were perfectly healthy.

SOURCE: Obstetrics & Gynecology, September 2006.