Undiagnosed Gestational Diabetes Ups Risk for Stillbirth
Women at risk for GDM who are screened, those diagnosed with GDM not at increased risk
MONDAY, April 1, 2019 (HealthDay News) -- Women at risk for gestational diabetes mellitus (GDM) who are not screened or diagnosed are more likely to experience stillbirth than women who undergo screening, according to a study published online March 19 in BJOG, an international journal of obstetrics and gynecology.
Tomasina Stacey, Ph.D., from the University of Leeds in the United Kingdom, and colleagues explored the effects of being at risk for GDM and screening for GDM and the effects of raised fasting plasma glucose (FPG; ≥5.6 mmol/l) and clinical diagnosis of GDM on the risks for late stillbirth. The analysis included 291 women who had a stillbirth ≥28 weeks of gestation and 733 women with an ongoing pregnancy.
The researchers found that women at risk for GDM who were not screened experienced greater risk for late stillbirth than those not at risk for GDM (adjusted odds ratio [aOR], 1.44; 95 percent confidence interval, 1.01 to 2.06). However, women at risk for GDM who were screened showed no increase in late stillbirth (aOR, 0.98; 95 percent confidence interval, 0.7 to 1.36). Women not diagnosed with GDM but with raised FPG experienced a fourfold greater risk for late stillbirth versus women with normal FPG (aOR, 4.22; 95 percent confidence interval, 1.04 to 17.02). This increase was not seen in women with raised FPG who were diagnosed with GDM (aOR, 1.1; 95 percent confidence interval, 0.31 to 3.91).
"Optimal screening and diagnosis of GDM mitigate the higher risks of late stillbirth in women 'at risk' of GDM and/or with raised FPG," the authors write.