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High risk of stillbirth for women with diabetes

Women with diabetes are seven times more likely to have a stillborn baby compared to other women.

These findings will be presented next week at Diabetes UK's Annual Professional Conference in Glasgow.

Research looking at 130 pregnancies in Leicester of women with Type 1 diabetes between 1999 and 2006 showed that 3.9 per cent resulted in stillbirth. This compares to 0.55 per cent according to a report on the pregnancy outcomes of all women.

In addition, the results from Leicester showed that Caesarean sections (58 per cent) and congenital malformations in the babies (5.4 per cent) were more than double the norm (23 per cent and 2 per cent). These findings are consistent with a national enquiry published in 2007.

Alarming findings

"Diabetes UK is alarmed by these findings," said Douglas Smallwood, Chief Executive of Diabetes UK.

Avoidable risks

"Many of the risks these women and their babies face are avoidable if they receive the appropriate preconception care and are supported to achieve good blood glucose control during their pregnancy.

"Sadly it appears we are making little progress in tackling the problem. It is unacceptable that women and their babies are exposed to these dangers unnecessarily."

Significant improvement

Dianne Todd, Specialist Midwife at the University Hospitals of Leicester NHS Trust, said: "We have known about the health issues of pregnant women with diabetes for some time and have, over the years, made significant improvement in our provision of care and pregnancy outcomes.

"These are high-risk pregnancies, which may be further complicated by additional medical and obstetric conditions. While we work hard to achieve good blood glucose control and a positive pregnancy outcome for all our women, pregnancy loss is often unpredictable.

Need for optimum care

"Our data is in-keeping with national figures and previous published reports. It serves to further emphasise the continuing need for optimum pre-conception and antenatal care."

Further pregnancy study

Pregnant women with Type 2 diabetes

Another study of 218 pregnancies of women with diabetes, also being presented at the conference, shows that women with Type 2 diabetes have a five-fold increased risk of having a baby with congenital malformations and more than twice as likely to miscarry compared to women with Type 1 diabetes.

Dr So Pye, researcher at Leicester General Hospital, said: "Our research showed that far fewer women with Type 2 diabetes planned their pregnancies, received pre-pregnancy counselling or took folic acid compared to women with Type 1 diabetes. In addition, the diabetes epidemic means that in the last decade the number of women with Type 2 diabetes of child-bearing age has dramatically increased.

Complex needs

"Type 2 diabetes is mainly managed by GPs who are having to cope with the complex needs of these women and are having to develop their expertise in this specialist area."

What Diabetes UK wants to see

To improve the chances of all women with diabetes having a healthy outcome, Diabetes UK wants to see them:

  • Provided with preconception care and counselling that emphasises the need to keep tight control of their diabetes.
  • Encouraged to take appropriate doses of folic acid to reduce the risk of defects.
  • Informed of the benefits of breastfeeding and supported to follow this choice after delivery.
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