Causes of Pregnancy Loss Differ in Women With Type 1 or Type 2 Diabetes

Rates of pregnancy loss and neonatal deaths are similar among women with type 1 or type 2 diabetes, investigators in New Zealand report, but the causes of pregnancy loss vary between the two groups. Dr. Tim Cundy at the University of Auckland and associates analyzed prospectively collected data on women with diabetes treated at the Diabetes Pregnancy Service at Auckland City Hospital between 1986 and 2005. Included were 349 women with type 1 diabetes and 862 with type 2 diabetes. Forty-two pregnancy losses were documented.

The rates of pregnancy loss were 2.6% in type 1 and 3.7% in type 2 diabetes, a nonsignificant difference, the report indicates. Glucose control, as measured by levels of glycosylated hemoglobin, did not differ significantly between groups at presentation and near term.

Dr. Cundy and colleagues report that, in type 1 diabetes, the main causes (of pregnancy loss) were major congenital anomalies and neonatal complications of prematurity.

By contrast, the most common reasons among type 2 diabetics were stillbirth and chorioamnionitis, which were "strikingly more prevalent" than in women with type 1 diabetes, the investigators found.

They note that women with type 2 diabetes had significantly greater body mass index and were more commonly of non-European descent (p < 0.0001 for each).

Dr. Cundy’s team concludes that "factors in addition to glycemic control have a substantial impact on both the rates and causes of pregnancy loss" among women with diabetes.

Diabetes Care Oct, 2007;30:2603-2607.

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