"Deal with your obesity and diabetes before getting pregnant."
While it is already well known that obesity is linked to problems during pregnancy, less is known about diabetes and what causes problems when a pregnant woman has both conditions. University of Rochester Medical Center researchers Loralei Thornburg, M.D., and Kristin Knight, M.D., wanted to see if obesity alone is the reason for the higher risks in women with both conditions, or if diabetes also played a part.
They found that obese women who also had diabetes had worse pregnancies and deliveries compared to women of the same weight who did not have diabetes. Women with both conditions also had less healthy babies that those who did not have diabetes.
Women and their doctors need to know that each condition raises risk during pregnancy, says Dr. Knight. When a women has both conditions, she should be even more worried.
Luckily, Dr. Knight continues, many women may be willing to take some steps to reduce their risks. Because pregnancy is a time of great change, women may be more open to making other changes to their lifestyle, such as getting blood sugar under control, exercising, and eating healthy foods. Making these kind of lifestyle changes may help a woman have a healthier baby.
Dr. Thornburg and Dr. Knight came to these conclusions by looking at 213 pairs of women who gave birth at the University of Rochester Medical Center between 2000 and 2008. Each pair consisted of one women with diabetes and one without diabetes. Each pair was also matched without about the same body mass index (BMI) - a measure of body fat that uses height and weight. Most of the women in the study were overweight, obese, or morbidly obese.
After controlling for other possible influences, such as age and smoking, the researchers found that the women with type 2 diabetes had worse pregnancies than those without the disease. The women with diabetes had higher rates of preeclampsia (high blood pressure and protein in the urine), cesarean delivery (a surgery to remove the baby), shoulder dystocia (when the infant's shoulder can pass through part of the pubic bone), premature birth, heavier infants, and infants that needed to go to the neonatal intensive care unit.
This topic is especially important to study, the researchers say, because rates of obesity and type 2 diabetes are quickly rising in women of childbearing age. According to a study in the Journal of the American Medical Association, over 35 percent of adult women in the United States were obese between 2007 and 2008. The Centers for Disease Control and Prevention (CDC) says that about 11 percent of women over the age of 20 were affected by diabetes in 2010.
The results of this study are published in The Journal of Maternal-Fetal and Neonatal Medicine.