Pregnancy

Facts
Pre-conception
Pregnancy
Caesarean Section
Report – Diabetes in Pregnancy: Caring for baby after birth [2007]
Breastfeeding and Weaning
Insulin analogues and pregnancy
Gestational Diabetes
Research – Pregnancy

Research – Pregnancy

Physical activity before pregnancy may reduce the risk of gestational diabetes

In this study a questionnaire about physical activity and sedentary behaviour was used and information analysed from 21,765 women who reported at least one 1 pregnancy between 1990 and 1998. 

There were 1428 cases of gestational diabetes and after taking into account body mass index, dietary factors etc, the results showed that the risk of gestational diabetes was significantly less in women who took vigorous activity before pregnancy. Equally brisk walking pace was associated with significantly lower risk compared with an easy pace.

Women who spent 20 hours per week or more watching television but did not perform vigorous activity had a significantly higher risk of gestational diabetes than women who spent less than 2 hours per week watching television and were physically active. 

The scientists concluded that the study provides strong evidence that regular physical activity before pregnancy is associated with lower risk of gestational diabetes.

Diabetes Care May 2006

The longer a woman breastfeeds, the less likely her child will become overweight later

Breastfeeding longer than three months can cut  a child’s risk by 40%, of becoming overweight or obese by the age of 8 if the child was born to an overweight mother diagnosed with gestational diabetes during her pregnancy. 

The study carried out in Germany included 324 children born between 1995-2000 to women with gestational diabetes. More that 37% of children who were never breastfed had become overweight by the age of 8. Of those who were breastfed for up to three months, 32.5% became overweight children but of those who were breastfed longer than three months, only 22% became overweight.

The study also found, however, that obese women, whose children were therefore at greater risk for obesity, were less motivated to breastfeed than non-obese women and twice as likely to forego breastfeeding their children as women of healthier weights.

The researchers recommend anyone diagnosed with gestational diabetes to breast feed for as many months as possible to reduce the risk of their children gaining excessive weight as they grow up and is a means of getting children started on a path to good health.

Diabetes Care May 2006

Pesticides may increase the risk of gestational diabetes

Research has shown that exposure to agricultural pesticides during the first trimester increases the risk of a woman developing gestational diabetes. The study was carried amongst farmers wives.

Of 11,273 women who became pregnant 506 reported having gestational diabetes within 25 years after entering the study. 57% of the women had mixed or applied pesticides at some time in their life and the proportion was similar in those with and without gestational diabetes. However, women who mixed, applied or repaired pesticide equipment during the first trimester had a more than twofold increased risk of developing gestational diabetes. By contrast, women with residential exposure to pesticides or indirect exposure during the first trimester had no increased risk and nor did women who had mixed or applied pesticides before the study when they were not pregnant. 

This study may have significant public health benefits and farmers’ wives may be advised to avoid handling pesticides during pregnancy.

Diabetes Care, March 2007

Very tight versus tight control for diabetes in pregnancy
Pregnancies complicated by pre-existing Type 1 diabetes are high risk for a number of poor pregnancy and neonatal outcomes. The objective of this review was to assess the effects of very tight glycaemic control compared with tight control in women with Type 1 diabetes.

Main results: Two trials involving 182 women were involved. The two trials were difficult to compare. Maternal hypoglycaemia was more common among women whose diabetic control was very tight compared to tight control based on one trial. There was no difference detected in perinatal outcome between the groups.

Reviewers’ conclusions: There appears to be no clear evidence of benefit from very tight glycaemic control for pregnant diabetic women. Since very strict control may have a substantial impact on lifestyle, this suggests caution in advising such a tight degree of control.

Diabetes Care in Pregnancy, 3.12.02 reported in the British Medical Journal

Researchers in Norwich studied 158 pregnancies in women with Type 1 diabetes between 1991 and 2000 They divided them into two groups – one that had fair control and the other that had poor control of their blood glucose levels. The researchers defined adverse pregnancy outcome as spontaneous abortion, congenital malformation, still birth or infant death. They found that adverse outcome was fourfold higher in the poor control group compared to the fair control group. The poor control group had a ninefold increase in congenital malformation that was potentially life threatening or linked to long-term disability.

The authors of the study recommend that diabetic women and their carers need to be advised of the risks and encouraged to optimise glycaemic control before and during pregnancy.