A new study provides a clearer picture of the risk of diabetes associated with pregnancy

Diabetes during pregnancy (known as gestational diabetes) is associated with an increased likelihood of a number of complications for both mother and baby, including cesarean section, severe breathing problems and being overweight at birth, according to a study published BMJ today.

Researchers say their results “contribute to a better understanding of the adverse pregnancy outcomes associated with gestational diabetes».

Gestational diabetes develops when the body cannot produce enough insulin to control blood sugar levels during pregnancy, which can cause problems in both mothers and babies during pregnancy and after childbirth.

In 2008, a large study assessed the risks of adverse outcomes associated with gestational diabetes, but it did not adapt to some potentially influential (confusing) factors, and other important pregnancy outcomes were poorly reported, complicating firm conclusions.

To eliminate this uncertainty, researchers from Central Southern University in China analyzed data from 156 studies involving more than 7 million participants who reported pregnancy complications in women with gestational diabetes.

The studies were considered adjusted if they took into account at least one of seven mixing factors (mother’s age, pre-pregnancy body mass index, weight gain during pregnancy, number of previous pregnancies, number of previous births, smoking history and chronic high blood pressure).

To assess the impact of varying degrees of gestational diabetes, researchers have classified studies on insulin use (considered standard treatment for gestational diabetes if adequate blood sugar is not achieved through diet and exercise).

They then conducted an analysis based on the country of study (developed or developing), the quality of the study, the diagnostic criteria and the screening method used.

In studies without the use of insulin, adjusted for embarrassment, they found that women with gestational diabetes are more likely to cesarean sectionpremature births, low Apgar score per minute (indicator of the state of the child at birth), overweight at birth and children born larger for gestational age than those without diabetes.

In studies using insulin, adjusted for embarrassment, they found that children were more likely to be born for gestational age or with respiratory distress syndromeneonatal jaundice or requiring hospitalization in the neonatal intensive care unit were higher in women with gestational diabetes than in those who did not have diabetes.

They found no clear differences in the chances of a number of other outcomes, including instrumental childbirth (e.g., use of forceps), heavy postpartum hemorrhage (postpartum hemorrhage), stillbirth, neonatal death, and low birth weight between women with and without gestational diabetes. , after adjustment on the mixer.

These are the results of observations, so the cause cannot be established, and researchers cannot rule out the possibility that other unmeasured factors influenced their results. Differences in the definitions of diabetes in the study and some pregnancy outcomes could also be affected.

However, this is the most in-depth analysis of its kind to date, which researchers say[s] for a fuller understanding of the adverse pregnancy outcomes associated with gestational diabetes ”.

Thus, they conclude: “These findings confirm the need for a better understanding of the pathophysiology of gestational diabetes in order to predict the risk and take precautions to reduce adverse outcomes. pregnancy».

And they say future primary research “should regularly consider adjusting for a more complete set of prognostic factors.”