Type 2 diabetes may lead to pregnancy complications independent of obesity

Obesity is a well-established risk factor for pregnancy complications, but what happens when the mother-to-be also has type 2 diabetes? New research suggests that the metabolic condition dramatically compounds the chances of experiencing potentially serious complications.

The University of Rochester researchers said that their findings are extremely important today, given the skyrocketing obesity and diabetes rates among women of child-bearing age. More than 35 percent of adult women in the U.S. are obese and 11 percent of those over the age of 20 have type 2 diabetes.

Obesity is well known to increase the risk of pregnancy complications, including preterm birth, large birth weight, blood loss during delivery and birth trauma. However, the effects of a mother's type 2 diabetes were less understood.

To investigate the matter, the researchers analyzed the medical records of 213 pairs of women who gave birth between 2000 and 2008. Each pair was matched based on their body mass index and one member of each unit had type 2 diabetes. The majority of participants, regardless of whether or not they had diabetes, were overweight or obese. The findings were published in the Journal of Maternal-Fetal and Neonatal Medicine.

As expected, the women who were overweight or obese experienced a higher rate of birth complications than those who had healthier BMIs. However, the women who had type 2 diabetes experienced significantly more problems during delivery than their BMI-matched counterparts.

Women with type 2 diabetes had much higher rates of preeclampsia, cesarean delivery, shoulder dystocia, preterm delivery, large-for-gestational-age infant, fetal anomaly and admission to the neonatal intensive care unit.

Kristin Knight, MD, who participated in the research, said that the findings show that both diabetes and obesity independently increase the risk of pregnancy complications, something that should be brought to the attention of doctors and their patients.

"Women and their physicians need to be aware that each condition on its own increases risk in pregnancy, so when they coexist the situation is even more worrisome," she said. "Anything a woman can do to improve her condition, from controlling blood sugar and exercising, to eating nutritious foods and maintaining an optimal weight, will help her deliver a healthier baby."

With type 2 diabetes rates rising to historic highs, the findings could have implications for millions of women.