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GLASGOW: New study suggests that pregnant women with diabetes are more likely to have a stillborn child in case of obesity or poorly controlled blood sugar.
Even without these additional health problems, pregnant women with diabetes who are pregnant are at risk of stillbirth four to five times higher than non-diabetic women, and this risk has remained stubbornly high, even though stillbirth rates have decreased the general population, noted researchers in Diabetologia. .
For this study, researchers examined data on diabetic mothers who gave birth in Scotland between 1998 and 2016.
About 70% of deliveries occurred in women with type 1 diabetes, the least common form of the disease, which develops in childhood or adulthood when the pancreas can not produce the disease. insulin. In type 2 diabetes, linked to obesity and aging, the body can not properly use or produce enough insulin to convert blood sugar into energy.
Overall, the stillbirth rates were 16.1 per 1,000 deliveries with type 1 diabetes and 22.9 per 1,000 deliveries with type 2 diabetes.
With type 1 diabetes, higher blood glucose before conception or in late pregnancy was badociated with stillbirth rates of 3% to 6% higher.
For type 2 diabetes, elevated blood glucose prior to conception was badociated with a 2% higher stillbirth risk, while a high BMI increased the risk by 7%.
Although most stillbirths occurred when the fetus was premature, about one third occurred when the pregnancy was complete.
"The question must be asked whether an early delivery of diabetic pregnancies could prevent these stillbirths in the long run, but we do not know the answer to this question," said Dr. Sharon Mackin, lead author of the study and researcher at Glasgow University in Scotland.
"The optimal time for a pregnancy complicated by diabetes is not clear," Mackin told by email.
The absolute risk of stillbirth was highest in small infants for gestational age, especially for mothers with type 1 diabetes.
Stillbirths were also more likely among infants who were tall for their gestational age for mothers with both types of diabetes.
The study was not a controlled experiment designed to prove whether or how specific factors could directly cause stillbirth in women with diabetes.
One limitation is that diabetes treatments changed dramatically during the study period and may have had an impact on stillbirth rates.
The researchers also lacked data on some patient characteristics that could affect the outcome of the birth and had no details in the death certificates to confirm the possible causes of each stillbirth.
Doctors are currently advising women with diabetes to give birth during the 38th week of pregnancy, Mackin said.
Earlier and babies might have an increased risk of breathing problems due to immature lung development.
"The risk of such breathing problems is higher in the 37th week than in the following weeks," said Mackin.
"I think it's a key area of research that needs to be further explored before we can make any other recommendations to change the way we look." routine for women giving birth. "
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