Haemoglobin A1 in diabetic pregnancy: An evaluation

Periconceptional Metabolic Status and Risk for Spontaneous Abortion in Insulin-Dependent Diabetic Pregnancies

“…A spontaneous abortion rate of 30% was documented. Since similar studies done in nondiabetic pregnancies with a similar prospective approach showed spontaneous, clinically apparent abortion rates not exceeding 15%, 4~6 -29 ' 30 it was concluded that the spontaneous abortion rate in insulin-dependent diabetic pregnancies was high and most likely increased Mengert and Laughlin 31 Patterson and Burnstein 32 Hall and Tillman 33 * Moss and Mullholand 34 White 35 § Adams 36 Clayton 37 Gellis and Hsia 38 Kitzmiller et al 1 Drury 39 Crane and Wahl 40 Sheridan-Pereira et al 41 Miodovnik et al 42 Sutherland and Pritchard 43 * 1937 1939 1949 1951 1951 1952 1955 1956 1959 1978 1979 1981 1983 1984 1986 No. when compared with the normal, nondiabetic population.…”

“…In 1937 White 3 noted that the abortion rate in diabetic pregnancy decreased by half temporally after the introduction of insulin therapy. Four decades later Sheridan-Pereira and collaborators 41 suggested in a report that poor metabolic control (assessed by measurement of glycohemoglobin A t ) in the first trimester placed the insulin-dependent diabetic mother at an increased risk of fetal loss. Their study included 88 pregnancies in 85 patients.…”

Diabetes Mellitus: Effects on Oocyte and Pre-Implantation Embryo Growth and Development

“…1 These problems occur late in pregnancy leading to significant neonatal morbidity and mortality 2 ; early to mid-pregnancy during the period of organogenesis, leading to congenital malformations 3 ; and early in pregnancy resulting in spontaneous abortions. [4][5][6] Institution of strict metabolic control during pregnancy has significantly lowered the morbidity and mortality rates. 7 The increased incidence of congenital malformations, however, persists unless blood glucose levels are well regulated during the period of organogenesis, as has been demonstrated both clinically and in experimental diabetic animals 3 ' 8 ; although this conclusion has been disputed.…”