Early Delivery an Option for Diabetic Mothers at High Stillbirth Risk

A new study by researchers at the University of Glasgow has found that diabetic women are four times more likely to experience the stillbirth of a baby than women who do not suffer from the lifelong health condition.

The study examined the birth outcomes of around 4,000 diabetic mothers living in Scotland and found that high blood glucose levels during pregnancy were a significant “risk factor” for stillbirth; furthermore, those who also recorded a high BMI (Body Mass Index) were even more likely to give birth to a stillborn baby.

The researchers calculated the stillbirth risk as follows:

  • 0.5% for women without diabetes
  • 1.6% for women with type 1 diabetes
  • 2.3% for women with type 2 diabetes

Early delivery could be the answer

One-third of all the stillbirths documented in the research happened at full-term. This has led to suggestions that early, induced or caesarean delivery may be a suitable option for pregnant women who suffer from diabetes. However, the study could be important in other ways as it could lead to greater support for diabetic women during pregnancy.

Dr Sharon Mackin, the study’s lead researcher, commented, “It is vital that we, as healthcare professionals, find better ways to support women during their fertile ages to optimise weight and blood sugar, so that when entering pregnancy, whether that be planned or unplanned, they are better prepared and their risk of adverse outcomes is reduced.”

One possibility being mooted is the provision of “pre-conceptual counselling” that might help pregnant women better prepare to minimise risks during any planned pregnancy, while support from regular diabetes clinics may also be able to help women reduce blood sugar levels and lower their BMI, thereby fostering improved outcomes.

But it is early delivery that is likely to have the greatest impact as it may drastically reduce the numbers of stillbirths.

However, Doctor Mackin cautioned that “the optimal timing of delivery in such pregnancies is not clear.”

Furthermore, the NHS recently cautioned that babies born preterm have a greater risk of developing newborn respiratory distress syndrome (NRDS), a condition in which the underdeveloped lungs of a newborn are unable to provide sufficient oxygen.

To further complicate matters, diabetic mothers are more likely to have babies with NRDS.

“Changes in routine delivery guidelines has to be balanced against the risk of an infant developing breathing problems as a result of immature lung development,” commented Doctor Mackin.

“The risk of such breathing problems is higher at 37 weeks than at later weeks. We think this is a key area of research that needs to be explored further, before any further recommendations can be made for early delivery.”