The magazine of the European Association for the Study of Diabetes- shows a greater risk of adverse results in babies born of mothers with gestational diabetes compared to non-diabetic mothers.
A new research published in 'Diabetology'-the magazine of the European Association for the study of diabetes-shows a greater risk of adverse results in babies born to mothers with gestational diabetes compared to non-diabetic mothers.
The proportion of overweight or obesity women is increasing in almost all countries of the world and this is accompanied by a greater risk of developing type 2 diabetes (DT2)-whether pregnant or not-and gestational diabetes, a form of diabetes thatIt is experienced only during pregnancy.
Although other studies have analyzed the links between gestational diabetes and adverse results in babies, the very large analyzes that focus on a complete national database are very scarce, such as that used in this work carried out by French researchers.
In this new investigation, the 796,346 deliveries that were after 22 weeks in France in 2012 were included through the data extraction from the hospital discharge database and the National Health Insurance System.The diabetic state of mothers was determined by the use of drugs for diabetes or insulin to reduce blood sugar, and by hospital diagnosis.
The results were analyzed according to the type of diabetes and, in the gestational diabetes group, whether or not diabetes were treated.In high -income countries, although most women with gestational diabetes are treated with diet at the beginning, around one in four women suffer from serious or difficult gestational diabetes to control that needs insulin treatment.The remaining 75 percent of women with gestational diabetes remain treated.
The cohort of 796,346 deliveries contained 57,629 mothers (7.24 percent) with gestational diabetes and there were 705,198 deliveries (88 percent of the total) with available data that linked the mother with the child.The risks of adverse results were two to four times higher for mothers babies with type 2 diabetes before pregnancy (pre -war diabetes) than for those with gestational diabetes.
Then, the authors adjusted their data, limiting the analysis to births after 28 weeks of gestation, to ensure that all women diagnosed with gestational diabetes were included in the analysis, since the diagnosis of gestational diabetes occurs in mostof cases at 28 weeks or later).
Premature delivery, macrosomia or cardiac malformations, possible problems
After the adjustment, the risk of several complications for mothers with gestational diabetes against mothers without the pathology increased: 30 percent for premature birth;40 percent of caesarean section;70 percent of preeclampsia/eclampsia;80 percent of babies born significantly larger than the average size (macrosomia);a 10 percent respiratory distress;30 percent of birth trauma and 30 percent cardiac malformations.
Although these greatest risks occur for women with gestational diabetes treated with insulin and diet, most of the higher risk was found in women treated with insulin.This is because diabetes is more serious and blood sugar more difficult to control in women who need insulin treatment, resulting in a greater risk of complications than in women treated only with diet.
After limiting the analysis to normal births (37 weeks), a higher risk was observedof death of the newborn in women with gestational diabetes and after excluding the suspicious women of having been diagnosed with type 2 diabetes before pregnancy, the risk remained moderately high only for those women with gestational diabetes treated with diet, with a 30 by 30 byone hundred more risk of dying.
The researchers suggest that this difference in the risk of death could be due to the fact that women with gestational diabetes treated with diet tend to give birth later than those treated with insulin, which means that the unborn child is exposed to levelshigher glucose for longer.
