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Women with diabetes need improved care during pregnancy

Novel approaches and technologies are needed to improve perinatal care for women with diabetes, researchers say

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Scientists are urging improved perinatal care for women with diabetes in light of their research.

A study by Glasgow University has added weight to assertions that type 1 (T1D) and type 2 diabetes (T2D) can affect birth outcomes.

Data was drawn from the Scottish Morbidity Record 02 for babies born in Scotland between April 1998 and March 2013, and the Scottish Care Information Diabetes Collaboration to check for the condition.

Of the 813,921 deliveries in the study period, 4,681 were to mothers with pre-gestational T1D or T2D.

Major unmet need

There were 104 perinatal deaths in children of mothers with diabetes, equating to a mortality rate 4.2 times higher than the rest of the Scottish population in T1D, and 3.1 times higher in T2D.

Stillbirths were four times more likely in T1D and five times more likely in T2D than in women without diabetes.

High birthweights and large for gestational age outcomes were also more likely in women with diabetes, while obstetric intervention, such as elective or emergency caesarean section, occurred in 68% of births to T1D women and 60% of births to T2D women.

That compares with 24% in the general population.

The researchers concluded: ‘There is a major unmet need to improve perinatal outcomes for women with diabetes treated during pregnancy. Novel approaches and technologies will be needed.’

Mackin S et al (2017) Diabetes and pregnancy: national trends over a 15-year period. Diabetologia. doi:10.1007/s00125-017-4529-3


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