posted 11/13/02
Pregnant women who were diagnosed with diabetes before their pregnancy are more
likely to give birth to infants with birth defects, researchers report.
The most common birth defects identified in the
study involved the brain, spinal cord, heart, and gastrointestinal tract.
This finding does not mean that all women with
diabetes should fear for their unborn children, said lead researcher, Dr. Jeanne
S. Sheffield of the University of Texas Southwestern Medical Center in Dallas.
There are ways for diabetic women to reduce their risk; previous research has
shown that the more women control their blood sugar (glucose) levels the less
likely their babies are to have birth defects.
"If (diabetic women) are even thinking about
getting pregnant, the best thing they could do is to get their sugars under
control," Sheffield advised.
The investigators gathered information on all
women who delivered babies at Parkland Hospital in Dallas between January 1991
and December 2000. They identified women who had diabetes and determined whether
they were diagnosed before becoming pregnant or during the pregnancy. Some women
develop diabetes during pregnancy, a condition called gestational diabetes. The
team considered gestational diabetes to be mild if the women did not need
insulin to control their glucose levels, instead relying solely on regulating
their diets.
In the November issue of Obstetrics & Gynecology,
Sheffield and her colleagues report that out of 145,196 women who delivered
babies during the study period, 2,687 (almost 2%) had diabetes. Of those, 410
(0.3%) were diagnosed with diabetes before they conceived.
Infants were born with malformations to 1.5% of
women without diabetes, to 1.2% of women with mild diabetes that developed
during pregnancy, and to 4.8% and 6.1% of women with more severe forms of
diabetes diagnosed during pregnancy and those with pre-existing diabetes,
respectively.
Sheffield and colleagues calculated that women
with pre-existing diabetes or severe diabetes that develops during pregnancy are
between 3 and 4 times more likely than other women to give birth to infants with
birth defects.
Dr. Sheffield explained that the risk of birth
defects in women with diabetes results from the mother's relatively high glucose
levels right before conceiving and during the first few months of pregnancy.
She added that doctors have long known that women
with diabetes have a higher than average risk of giving birth to a child with
birth defects. However, Sheffield explained that this study has advantages over
previous investigations because it includes a relatively large number of women
who were treated in the same environment, and the research was conducted by the
same people, reducing the risk of confounding influences.
Sheffield noted that women with mild diabetes that develops during pregnancy should be encouraged by the current study findings. "Their risk is no different than the general population," she said.
Source: Diabetes In Control Dot
Com: Obstetrics & Gynecology 2002;100:925-930.
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