IRISH WOMEN with diabetes are poorly prepared for pregnancy and their babies are more likely to die than those born to women without the disease, new research has found.
Dr Fidelma Dunne, consultant endocrinologist at University Hospital Galway and senior lecturer in medicine at the National University of Ireland Galway, and her colleagues recruited pregnant women with diabetes who attended five hospitals along the Atlantic seaboard during 2006 and 2007.
The diabetes in pregnancy study (Atlantic – DIP), funded by the Health Research Board (HRB), set out to profile the quality of care and pregnancy outcomes of some 102 women.
Just 38 per cent of pregnant women with diabetes had a normal body mass index (BMI), with 27 per cent officially classified as obese. And some 20 per cent had already developed complications from their diabetes, such as kidney and eye problems, despite their relatively young age.
Fewer than one in three women had attended a pre-pregnancy clinic contrary to best practice guidelines.
According to Dr Dunne, a period of three to six months preparing for pregnancy is recommended. “During this time, the woman’s blood sugars are optimised, her diet is reviewed and folic acid [5mg ]is given for a minimum of 12 weeks,” she said, adding that pre-pregnancy care had been shown to improve pregnancy outcomes for both mother and baby.
The study of women attending hospitals in Letterkenny, Sligo, Ballinasloe, Castlebar and Galway found the stillbirth rate for babies of mothers with diabetes was seven times that of other mothers in the west of Ireland. The perinatal mortality rate – baby deaths between the 28th week of pregnancy and the end of the first week of life – was five times the rate found among women without the disease.
The rate of miscarriage in women with diabetes was higher, with 20 per cent of the women studied suffering the loss of a pregnancy. Diabetic mothers were more likely to deliver their babies prematurely and were twice as likely to have a baby with a congenital malformation.
Asked what was needed to improve the health outcomes for pregnant women with diabetes and their babies, Dr Dunne said the study authors were working with the regional Diabetes Services Advisory Group (DSAG) to “ensure the results of the study are fed upwards to the decision makers in the HSE and the Department of Health”.
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