August 14, 2006

Pre-pregnancy care cuts risks for diabetics

NEW YORK (Reuters Health) - Getting medical care before
pregnancy can help women with diabetes control their blood
sugar early in pregnancy, and can also reduce the risk of some
complications, a new study shows.

Women with type 1 diabetes are more likely to have children
with birth defects and babies that die shortly after birth.
There is strong evidence that this risk is linked to how
tightly blood sugar is controlled early in pregnancy, while the
fetus' organs are still forming, Dr. Rosemary C. Temple of
Norfolk and Norwich University Hospital in Norwich, UK, and her
colleagues write in the journal Diabetes Care.

The only way to ensure that blood sugar is well controlled
this early in pregnancy, the team notes, is for women to get
care before pregnancy.

To investigate whether attending a clinic for care before
pregnancy would in fact improve pregnancy outcomes for diabetic
women, the researchers followed 290 pregnant women with type 1
diabetes, 110 of whom received pre-pregnancy care.

Women who got pre-pregnancy care had better blood sugar
control for the first half of pregnancy. Just 2.9 percent had
adverse pregnancy outcomes such as stillbirth, infant
deformities or infant death, compared to 10.2 percent of women
who did not get pre-pregnancy care. Five percent of women who
got care before pregnancy had very premature infants, compared
to 14.2 percent of women who didn't get care before pregnancy.

However, the researchers found, pre-pregnancy care had no
effect on blood sugar control in later pregnancy or the risk of
having a very large baby, which is common with diabetic women.

Even so, given the early benefits, they conclude by urging
doctors and scientists to find ways to improve diabetic women's
use of pre-pregnancy services, and determine whether such
services can help women with type 2 diabetes as well.