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Pregnant women with diabetes are almost four times more likely to have a baby with a birth defect than women without the condition, warn researchers. Their findings suggest that higher blood sugar levels in the mother raise the risk. Around one in 13 babies born to a woman with type 1 or type 2 diabetes is affected by a major birth defect, such as heart disease and spina bifida. This compares with a risk of one in 50 for women without diabetes.
Doctors at the charity Diabetes UK, which funded the study, are urging women with diabetes who want to start a family to take advice about getting good glucose control first to minimise the risk. But they stressed that the vast majority of pregnancies in women with diabetes did not involve a birth defect.
The study, led by researchers at Newcastle University and the Regional Maternity Survey Office, looked at the outcomes of 401,149 pregnancies, including 1,677 pregnancies in women with diabetes, between 1996 and 2008 in the North of England. Researcher Ruth Bell told the journal Diabetologia: ‘The good news is that, with expert help before and during pregnancy, most women with diabetes will have a healthy baby.
'The risk of problems can be reduced by taking extra care to have the best possible glucose control before becoming pregnant.’ The study examined 401,149 pregnancies born between 1996 and 2008 'Any reduction in high glucose levels is likely to improve the chances of a healthy baby. ‘All young women with diabetes need to know about preparing for pregnancy, and should contact their doctor or diabetes team as soon as possible if they are thinking about pregnancy or become pregnant.’
Previous research shows having diabetes increases the chance of birth defects, but this is one of the first studies to quantify the effect of glucose levels on risk. Higher blood sugar levels can be reduced using lifestyle and diet, or changes to medication during pregnancy. Dr Iain Frame, Director of Research for Diabetes UK, said ‘The real message from this study is that the blood glucose level of the mother is important to the risk.
‘This study offers clear evidence that although women with diabetes might still have a higher risk of a birth defect, they can still do something positive to reduce that risk by carefully monitoring their blood glucose level and trying to reduce it if it is high. ‘We need to get the message out to women with diabetes that if they are considering becoming pregnant, then they should tell their diabetes healthcare team, who will make sure they are aware of planning and what next steps they should be taking.
‘Blood glucose control continues to be important throughout pregnancy and should be closely monitored to ensure the best result for the baby and this is why women should be as prepared as possible beforehand.’ He said women with diabetes who were sexually active but not planning a baby should use contraception. ‘This is because as well as high blood glucose levels increasing risk of birth defect, some medications taken by people with Type 2 diabetes can cause problems in the developing foetus and higher doses of folic acid are needed for women with diabetes to reduce the risk of complications such as spina bifida’ he added..
Birth defects include congenital heart disease and defects of the nervous system such as spina bifida. Many can be treated but some result in stillbirth or pregnancy loss or ongoing health problems. The study did not look at women who developed diabetes - gestational diabetes - during pregnancy.
Article: 6th February 2012 www.dailymail.co.uk