Pregnancy complications high even when diabetes is under control

Risk of complications of pregnancy in women with type 1 diabetes: nationwide prospective study in the Netherlands – BMJ Online First Publication

Women with diabetes are at an increased risk of pregnancy complications, even if their diabetes is well controlled, according to new research. These findings suggest that the current criteria for strict blood sugar (glycaemic) control before and during pregnancy are not good enough.

This study will be available on bmj.com on Monday 5 April 2004.

Researchers in the Netherlands surveyed 323 women with type 1 diabetes who became pregnant between 1999 and 2000. The women filled out three questionnaires during their pregnancy and glycaemic control was monitored. Complications were compared with national data.

Most (84%) of the pregnancies were planned, resulting in overall good glycaemic control (HbA1c) early in pregnancy and a high rate of folic acid use. Despite this, complications such as pre-eclampsia, high birth weight, and birth defects were still considerably higher than in the general population. Many infants also had dangerously low blood sugar levels (hypoglycaemia).

This study shows that the goals of the St Vincent Declaration for outcome of pregnancy in women with diabetes are still not being met, say the authors.

Although most women planned their pregnancy and prepared well, outcome was not comparable to that of the general population. Near optimal glycaemic control is apparently not good enough, they conclude.