A recent study underscores the significant risk that type 2 diabetes (T2D) poses to pregnant women, particularly in terms of perinatal mortality. This finding, published in the American Journal of Obstetrics & Gynecology, calls for a reevaluation of prenatal care strategies to address this growing concern.
T2D and Increased Perinatal Mortality Risk
The study reveals that pregnancies complicated by type 2 diabetes are associated with a heightened risk of perinatal mortality, surpassing the risks in other forms of diabetes. The risk is especially notable in women with early-onset T2D, where poor glycemic control exacerbates complications. Vulnerable populations, particularly non-White women in socioeconomically disadvantaged communities, face a disproportionate burden of these risks.
While some data suggests higher rates of stillbirths, congenital malformations, and perinatal deaths in T2D pregnancies, other studies show no significant difference compared to type 1 diabetes (T1D),” the authors note.
Study Methodology
To explore the impact of T2D on pregnancy outcomes, researchers conducted a meta-analysis comparing T2D pregnancies with those affected by T1D and gestational diabetes mellitus (GDM). The study reviewed literature published from 2009 to 2024, selecting research that met specific inclusion criteria. A total of 62 studies were deemed eligible for the analysis, which included 84,421 T2D pregnancies, 34,751 T1D pregnancies, 243,243 GDM pregnancies, and 5,398,613 pregnancies without diabetes as controls.
Key maternal and neonatal outcomes were examined, including rates of congenital malformations, stillbirth, neonatal and perinatal mortality, and various pregnancy complications such as diabetic ketoacidosis and preeclampsia.
Key Findings
The study found that pregnancies affected by T2D exhibited higher rates of chronic hypertension (17.1%) compared to T1D (7.6%), GDM (2.7%), and control pregnancies (0.7%). T2D patients were also more likely to deliver preterm and at an earlier gestational age, although they experienced fewer microvascular complications related to diabetes than their T1D counterparts.
Notably, the study revealed that T2D pregnancies were linked to increased risks of neonatal mortality (odds ratio [OR] = 1.53) and perinatal mortality (OR = 1.31). Compared to GDM pregnancies, those with T2D showed significantly higher risks for stillbirth (OR = 16.55), perinatal mortality (OR = 3.96), and congenital anomalies (OR = 1.91). These risks were also elevated when compared to pregnancies without diabetes, with T2D mothers facing higher odds of stillbirth (OR = 7.27), perinatal mortality (OR = 4.18), and congenital malformations (OR = 1.76).
Implications for Prenatal Care
The findings suggest that T2D pregnancies pose a greater risk for adverse outcomes, including perinatal mortality, when compared to other forms of diabetes. The study calls for further research to understand the underlying causes of these increased risks.
With T2D becoming more prevalent among women of reproductive age, the authors stress the need for improved prenatal care to mitigate these risks. “Given the rising prevalence of T2D in pregnant women, it is crucial that healthcare providers, researchers, and policymakers work together to address these risks and ensure better pregnancy outcomes for all women,” the study concludes.
Conclusion
This research highlights the urgent need to address the elevated perinatal mortality risk associated with type 2 diabetes in pregnancy. As T2D rates continue to climb, it is essential for healthcare strategies to evolve, ensuring the health and safety of both mothers and their babies.
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