Behind the headlines: shedding light on the risk of stillbirth
You might have seen the headlines today linking Type 1 and Type 2 diabetes to a higher risk of stillbirth.
We know news like this can be scary. And while it highlights an important issue, we want you to know the full story about the research behind the headlines, and what this might mean for you and your family.
Putting the research into context
Most women with diabetes have a healthy pregnancy and a healthy baby.
But having diabetes unfortunately increases your risk of serious complications during pregnancy and childbirth. One of these complications is stillbirth.
Because of this, women with diabetes are provided with specialist care both before and during their pregnancy. You can expect lots of appointments and scans, as your healthcare team closely monitor your health to make sure any risks are kept to an absolute minimum.
However, we need better ways to identify women most at risk of complications during their pregnancy and reduce their risk. The researchers behind this study aimed to do just that, by looking for specific factors linked to stillbirth.
They studied information on 5,392 babies born to 3,847 mothers with Type 1 or Type 2 diabetes in Scotland, between 1998 and 2016.
What did the research show?
The research team found that stillbirth occurred in 16 of every 1,000 births in women with Type 1 diabetes, and 23 of every 1,000 births in women with Type 2. In the general population, the rate was around five per 1,000 births.
This means that women with diabetes were roughly four times more likely to experience stillbirth than women without diabetes. But these numbers highlight that even with this increased risk, the chances of stillbirth are still very low.
And importantly, the team found ways to reduce this risk even further, with blood glucose levels being the most important factor.
Women with Type 1 diabetes were more likely to experience stillbirth if their blood glucose levels were higher than average both during and before pregnancy.
For women with Type 2 diabetes, pre-pregnancy blood glucose levels played the biggest role. And a higher BMI (body mass index) before pregnancy was found to increase the risk as well.
Stillbirths were more likely when pregnancies went to full term and when babies were smaller or larger than average, which raises important questions on how best to care for women with diabetes during their pregnancy in the future.
You can read the full research paper, published in Diabetologia, here.
What does this mean for women with diabetes?
There is good news. This research tells us that there are things we can do to reduce the risk of complications during pregnancy. They suggest that if you’re planning a pregnancy, this could be the best time to try to improve your blood glucose levels and (if you’re overweight and have Type 2 diabetes) try to reach a healthier weight for you.
This means that you should talk to your diabetes team ahead of getting pregnant and again as soon as you know you’re pregnant. This will help to make sure that you get the right level of care, both during preconception and pregnancy.
What if you’re pregnant already? Don’t panic. Your risk of complications is still very low, managing your weight and blood glucose levels will help to keep it there, and scientists are working hard to find ways to make it even lower.
For women with Type 1 diabetes, we now have evidence that continuous glucose monitoring (CGM) technology can improve blood glucose levels during pregnancy and reduce the risk of complications, when compared to finger prick testing alone. This has led to NHS England providing CGMs to all pregnant women with Type 1 diabetes, which is a great start.
Now, this latest study is a further step towards improving care for women with Type 1 and Type 2 diabetes.
We’re here to help
Bottom line, most women with diabetes have healthy pregnancies and healthy babies – but this research helps to build evidence around who is most at risk of complications and how to help them.
These findings could lead to more research to help reduce the risk of stillbirth, and help to improve guidelines for healthcare professionals – so they can provide you with the best care.
Meanwhile, we’re here for you. We have lots of useful information to help you plan a healthy pregnancy and manage your diabetes when you’re pregnant. And if you still have more questions, give our helpline a call.
We’re also funding research to make sure more and more women with diabetes have a pregnancy free of complications, from finding better ways to watch babies grow in the womb to helping pregnant women stay active.