HEALTH: Insulin risk to unborn babies

Pregnant women with insulin-dependent diabetes have a tenfold increased risk of bearing children with congenital abnormalities, says a clinical study published today. Their babies are also five times more likely than normal to be stillborn, according to the research.

Doctors from Liverpool University examined data on 462 pregnancies in 355 women with insulin-dependent diabetes (IDD) between 1990 and 1994.

The women were from 10 maternity units in Cheshire, Lancashire and Merseyside, which had no regional guidelines for the management of pregnancy in diabetic women.

Of the pregnancies, 78 (17 per cent) aborted spontaneously, nine (2 per cent) resulted in stillbirth, and 24 (5 per cent) were terminated. Of the terminations, nine were for congenital malformation.

Writing in the British Medical Journal, the authors said the problems could be reduced by good management of blood sugar levels before and at the time of conception. They added: "The challenge remains to implement this on a population basis."

The researchers, led by Dr Gillian Hawthorne from Hartlepool General Hospital, wrote: "Though two thirds of the pregnancies were planned by the mother, most women had not established good diabetic control before conception.

"Preconceptual care reduces major congenital malformations and the spontaneous abortion rate."