Stillbirths more likely if diabetes in pregnancy not diagnosed

Women are being left at risk of stillbirth due to a lack of consistency in screening for gestational diabetes, new research suggests.

Pregnant woman in third trimester having blood glucose levels checked.

20/03/2019

A new study has found that the risk of stillbirth is increased for women who developed signs of gestational diabetes but were left untreated.

Part funded by Tommy’s, the study compared the symptoms and care of 291 women across 41 maternity units in England.

Researchers found inconsistencies with gestational diabetes screening, with not all women who were at high risk of developing the condition tested according to current guidelines, and with 26% of those with the high risk factors not being screened at all.

According to recent figures, approximately 5% of women in the UK experience gestational diabetes during pregnancy.

The National Institute for Care Excellence (NICE) recommends that all women at a higher risk of gestational diabetes should receive blood screening for the condition: this includes women with a raised body mass index (a BMI of over 30), or from South Asian or Black Caribbean ethnic groups.

Co-author Professor Alexander Heazell, Clinical Director of Tommy's Stillbirth Research Centre, said:

It's not clear why some women missed out on being screened or diagnosed for gestational diabetes, but this needs to be improved. Gestational diabetes can cause serious complications in pregnancy. It's important that we detect every woman with symptoms so she can receive the appropriate care and support.

Left untreated, the condition can increase the risk of complications. These complications include a baby that grows larger than usual, leading to problems in labour; premature birth; pre-eclampsia and stillbirth.

The babies can also be at higher risks of obesity and diabetes later in life. 

Dr Tomasina Stacey, who led the study at the University of Leeds and now works at the University of Huddersfield, said:

The good news is that women with gestational diabetes have no increase in stillbirth risk if national guidelines are followed for screening, diagnosis and management. The bad news is that the guidelines are not always followed and some women therefore experience avoidably higher risk.

Gaynor Thompson from Halifax, was just two weeks away from her due date last October when her baby stopped moving.

After her daughter was stillborn, doctors concluded the most likely cause was undiagnosed gestational diabetes.

She had been tested for the condition at 26 weeks as was deemed at risk, but no further investigations were done after tests came back negative, as per national guidelines.

Mrs Thompson thinks those at risk should be tested routinely after 26 weeks, and a secondary compulsory test should be done later on in pregnancy.

She said:

What matters is going forward, what the doctors, the consultants, the NHS can learn from parents like us and [our daughter] Kallipateira, and action must be taken. There are far too many healthy, fully developed babies dying, which we do fully believe are preventable.

What is gestational diabetes 

The word ‘gestational’ simply means ‘relating to pregnancy’, so it is a type of diabetes that occurs during pregnancy. Most women with gestational diabetes have healthy pregnancies and healthy babies. However, sometimes gestational diabetes can cause problems for both you and your baby, particularly if it is not identified and treated.

Gestational diabetes can be thought of as an ‘early warning’ indicator that the woman has a higher than usual risk for type 2 diabetes in later life.

Causes of gestational diabetes

Researchers don't yet understand why some women get gestational diabetes and others don't. There are some risk factors that we have outlined below. If you have one or more of these then you are more likely to get gestational diabetes but doctors do not yet know why. Although a high BMI is a risk factor for gestational diabetes, women of all weights and sizes can also get it.

Read more about what causes gestational diabetes and the risk factors for getting it

Stillbirth research

Tommy’s research aims to reduce stillbirth rates by finding the missing links between stillbirth, the placenta, and the baby’s growth. Most of our stillbirth research takes place in our Manchester Research Centre, where we have made great progress in our Rainbow and Placenta Clinics. Research focuses on three main areas:

1. Understanding the causes

2. Treatment and prevention

3. Improving care for women at risk of, and following, a stillbirth

Read more about Tommy's stillbirth research here

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