NEW RESEARCH SHOWS that if a pregnant woman has diabetes, she is four times more at risk of having a child with birth defects.
The information came to light in a study undertaken by Newcastle University, which was published in the journal Diabetologia.
The researchers analysed data gleaned from 401,149 pregnancies in England between 1996 and 2008.
They saw that women with diabetes were more at risk of giving birth to babies with congenital heart disease and spina bifida.
The results showed that the rate of non-chromosomal major congenital anomaly in women with diabetes was 71.6 per 1000 pregnancies.
The unadjusted risk was higher for women from deprived areas or women who did not take folate (folic acid).
The type and duration of diabetes, ethnicity, age, BMI, preconception care, smoking and foetal sex were not associated with congenital anomaly risk.
The report showed that “pregnancies complicated by pre-existing diabetes are at high risk of adverse outcome, including stillbirth, perinatal mortality, congenital anomaly, Caesarean section and macrosomoia”.
The risk of congenital anomaly in women with diabetes is strongly associated with glycaemic control. However, similar rates of congenital anomaly have been reported in women with type 1 and 2 diabetes
Pregnancies in women with gestational diabetes were not included in the study.
Overall, one in 13 singleton deliveries (7.7 per cent) was affected, and the rate of non-chromosomal anomaly was almost four times higher than in women without pre-existing diabetes.
Among the researchers’ conclusions was that: “Awareness of the need for preparation for pregnancy should be incorporated into the routine care of young women with diabetes”.
Dr Ruth Bell, the lead researcher on the study, told the BBC that many of the anomalies happen in the first four to six weeks and that sugar levels in the lead-up to conception were an important risk factor.
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