Women with diabetes and obesity who are pregnant are more likely to suffer a stillbirth, a new study from Scotland finds.
For the study, researchers from the University of Glasgow and the University of Edinburgh in the U.K. looked at a large population of mothers with diabetes in Scotland from 1998-2006.
The researchers found the following results:
For mothers with Type 1 diabetes, the stillbirth rate was about 16 for every 1,000 deliveries.
For mothers with Type 2 diabetes, the stillbirth rate was 22.9 for every 1,000 deliveries.
For those with Type 1 diabetes, higher blood sugar before conception or during late pregnancy was associated with stillbirth rates that were 3% to 6% higher.
For those with Type 2 diabetes, elevated blood sugar before conception was tied to a 2% greater stillbirth risk, while higher BMI increased the risk by 7%.
The authors found stillbirths were also more likely among infants who were large for their gestational age for mothers with both types of diabetes.
The researchers acknowledge a few limitations to the study:
First, the study was an observational study, as opposed to a controlled experiment. It, therefore, did not examine the specific factors that may cause stillbirths among women with diabetes.
Another limitation of the study is that diabetes treatments have changed over the course of the study period, which may impact stillbirth rates.
In conclusion, the authors note maternal blood glucose level and BMI are the main risk factors associated with stillbirth in the population of women with diabetes they studied.
“However, there is significant overlap in values between live and stillborn groups making it difficult to predict exactly which pregnancies will end in stillbirth,” the authors note. “Achievement of near normoglycaemia remains key to reducing risk.”
They suggest methods of supporting women to improve blood glucose levels in pregnancy along with programs to optimize weight before pregnancy may help reduce stillbirth rates.
“Stillbirth rate remains high at term in women with diabetes in our population,” the authors conclude, “and until more accurate prediction of at-risk pregnancies is available, earlier delivery may be considered an attractive option.”
The study was supported by funding from the Chief Scientists Office of the Scottish Government and Glasgow Children’s Hospital Charity fund STM’s clinical research fellowship.