posted 12/06/02
A new study shows women with poorly controlled diabetes during early pregnancy have an increased risk of complications.
Researchers in Norwich, England observed 242 pregnancies in 158 women. They defined an adverse pregnancy outcome as spontaneous abortion, major congenital malformation, stillbirth, or infant death. Women were divided into two groups according to their level of blood glucose control. One group had fair control while the other group had poor control.
The American Diabetes Association recommends people with diabetes keep their hemoglobin AIC levels at about 7 percent. An AIC level is a measurement of what a person's average blood sugar has been for the previous three months. The women in this study with fair control had an AIC level of less than 7.5 percent. Those with poor control level had an AIC level of 7.5 percent or higher.
Results of the study show adverse outcome overall was more than four times higher in the poor control group than the fair control group. Spontaneous abortion was four times higher in the poor control group and major congenital malformation was nine times higher in that group. Stillbirth and infant death was slightly higher in the poor control group, but the difference was not significant.
Researchers found 32 pregnancies had an adverse outcome. Eighteen pregnancies resulted in spontaneous abortions, eight resulted in major congenital malformations, four resulted in stillbirths and two in neonatal deaths.
Authors of the study write, "Our findings suggest that good [glycemic] control around the time of conception is necessary to [optimize] outcome of pregnancy in diabetic women. Diabetic women and their carers need to be advised of the risks and encouraged to [optimize glycemic] control before and during pregnancy."
Source: Ivanhoe Newswire: British Medical Journal, 2002;325:1275-1276.
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