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    Type 2 Diabetes Threatens Pregnancy

    Birth Defects, Infant Deaths Higher for Women With Type 2 Diabetes

    Control Is Critical continued...

    There were four fetal or newborn deaths and four major birth defects among the 61 women, compared with no deaths and no major birth defects among the type 2 diabetes group who gave birth in the 1980s.

    The rate of preterm deliveries was twice as high in the former group, and these women also tended to be heavier and older than the women with type 2 who gave birth in 1980.

    The findings are published in the February issue of the journal Diabetes Care.

    Pregnancies Not Planned

    Clausen says the women with type 2 diabetes in the study tended to seek medical care during pregnancy later than women with type 1, with more than half waiting until the later parts of their pregnancy to see an obstetrician.

    She added that women with type 1 diabetes are much more likely to plan their pregnancies and get prepregnancy care than women with type 2 diabetes.

    Only 5% of the women with type 2 diabetes in the study had planned pregnancies. Because birth defects generally develop at the time a woman first becomes pregnant or during the first trimester, Clausen says it is critical that all women with diabetes have their disease under control before getting pregnant.

    "One of the best things a woman with diabetes can do to minimize the potential risk is to achieve good metabolic control before conception," she says.

    Endocrinologist Robert Rizza, MD, who is president-elect of the American Diabetes Association, agrees.

    "Historically, women didn't get type 2 diabetes until they were beyond their childbearing years, but that has changed," he tells WebMD. "That's why it is critical that younger women with type 2 diabetes control their blood pressure and blood (sugar) and try to get their weight under control."

    Obstetrician Donald Coustan, MD, says type 2 diabetes tends to be easier to control during pregnancy than type 1.

    "If a pregnant woman has undiagnosed type 2 diabetes, it makes sense that they might have a poorer outcome, but if we know about it we usually treat it," he tells WebMD.

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