The finding comes from analysis of data on more than 175,000 pregnant women
treated in Kaiser Permanente hospitals from 1999 through 2005. The researchers focused on the 2,784 births
to women who had type 1 or
type 2 diabetes at the time they became pregnant. They did not have
gestational diabetes, which develops for the first time during
In 1999, eight out of 1,000 births were to women who had type 1 or type 2
diabetes. By 2005, this more than doubled to 18 out of 1,000 births. And this
number includes only women who successfully gave birth. Diabetes is a major
risk factor for miscarriage, notes study researcher Jean M. Lawrence, MD, MPH,
of Kaiser Permanente.
"Type 1 and type 2 diabetes are more dangerous for the baby and
potentially harder to treat than gestational diabetes," Lawrence tells
WebMD. "It means that diabetes is with you the entire pregnancy --
particularly the crucial early stage of pregnancy, before women even know they
are pregnant. At this stage, high blood sugar can cause miscarriage and birth
Nobody knew Sandy Kaplan had diabetes when she had a miscarriage. For most
of their 10-year marriage, the 36-year old San Francisco Bay-area woman and her
husband have been trying for another pregnancy.
"I was not really working on diabetes control," Kaplan tells WebMD.
"I was a very heavyset girl. The doctors all said I just needed to lose
weight, but I said, "Yeah yeah yeah, uh-huh, it's the old fat girl thing
That changed when Kaplan finally got pregnant for the second time.
"When I got pregnant something snapped in my head. I thought, 'If I
really want to have a baby, I need to take care of myself," she says.
"So I went to Kaiser, and they got me into a program with a nutritionist.
It is really, really hard to lose weight when you are pregnant. I was about 300
pounds -- but I was down to around 230 when I had my daughter."
That daughter, now 4 months old, is perfectly healthy -- which means Kaplan
dodged a bullet, says Celia Dominguez, MD, assistant professor of gynecology
and obstetrics at Atlanta's Emory University.
"Whether it's type 1 or type 2 diabetes, when it is not well controlled,
even if the baby does make it there is a high risk of anomalies, ranging from
'mermaid' babies without bottom limbs to all kinds of other problems,"
Dominguez tells WebMD. "If mother's diabetes is not diagnosed or in poor
control, it can mean significant handicap to the child."
Although Lawrence's study did not distinguish between type 1 and type 2
diabetes, both she and Dominguez believe the increase in prepregnancy diabetes
is due to a surge in obesity-linked type 2 diabetes.
Dominguez says several trends are crashing together: growing obesity, a
delay in pregnancy, and a tendency for everyone to get heavier as they get
"We are literally now changing the face of pregnancy to encompass a
little more high risk," she says. "And with that increase in maternal
weight unfortunately come other problems like
high blood pressure. So do I see more pregnant women with type 2 diabetes
than I did two decades ago? Yes."