Recent research published in the American Journal of Obstetrics and Gynecology highlights a concerning trend: pregnant women with type 2 diabetes face higher risks for perinatal mortality compared to those with type 1 diabetes, gestational diabetes, or pregnancies without diabetes. The study points to the need for enhanced monitoring and care for this growing group of expectant mothers.
Over the past 15 years, the prevalence of type 2 diabetes in pregnant women has more than doubled, surpassing type 1 diabetes as the leading cause of preexisting diabetes in pregnancy in the U.K. By 2022, 55% of pregnancies complicated by pregestational diabetes were due to type 2 diabetes, compared to just 27% in 2003.
A systematic review and meta-analysis of 47 studies conducted from 2009 to 2024 assessed pregnancy outcomes in 84,421 women with type 2 diabetes, comparing them to women with type 1 diabetes (34,751), gestational diabetes (243,243), and pregnancies without diabetes (5,398,613). Key findings include:
Pregnant women with type 2 diabetes were more likely to deliver small for gestational age (SGA) infants compared to those with type 1 diabetes (OR = 2.52), and had higher risks for neonatal mortality (OR = 1.53) and perinatal mortality (OR = 1.31).
Compared to those with gestational diabetes, women with type 2 diabetes were at significantly greater risk of delivering large for gestational age (LGA) infants (OR = 3.49), infants with congenital anomalies (OR = 1.91), stillbirths (OR = 16.55), and perinatal mortality (OR = 3.96).
Women with type 2 diabetes were also more likely to have LGA infants (OR = 2.79), congenital anomalies (OR = 1.76), and stillbirths (OR = 7.27), along with a significantly higher risk for perinatal mortality (OR = 4.18), compared to those without diabetes.
These findings underscore the importance of closely monitoring pregnant women with type 2 diabetes to manage the elevated risks they face during pregnancy. Researchers stress the need for enhanced, supportive care before and during pregnancy to improve outcomes for both mothers and children, and to address long-term health disparities.
With the growing prevalence of type 2 diabetes among women of childbearing age, this research calls for greater awareness among healthcare professionals, policymakers, and researchers to optimize care for these mothers and reduce health inequalities.
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