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

Abstract

The rate of clinically apparent spontaneous abortions in insulin-dependent diabetic pregnancies has been prospectively determined to be twice as frequent as for the general population (29.5% versus 10 to 15%). In a series of several successive studies, we have shown that spontaneous abortions are associated with poor metabolic control around conception and/or in the early weeks of pregnancy, but not in the 1 to 2 weeks preceding the abortive event itself. There is also a significant relationship between decreased maternal magnesium status (as assessed by maternal serum magnesium concentration) and adverse fetal outcome (spontaneous abortion and/or major congenital malformations) in insulin-dependent diabetic women. We speculate that improvement of glycemic control and of magnesium status before conception and in the very early phases of organogenesis might improve embryonic and fetal survival.

A population‐based survey of frequencies of self‐reported spontaneous and induced abortions in Danish women with Type 1 diabetes mellitus

“…In a prospective study from Sweden, the SA frequency in the nondiabetic control group was 7.2% [17]. These rates are close to the crude rate of clinically veri®ed SA frequencies of 10±15% reported from several non-Scandinavian populations [7,13,14].…”

“…However, whether pregnant women with Type 1 diabetes mellitus (DM) still have an increased risk of spontaneous abortions (SA) is controversial. The frequency of recognized SA in Caucasoid women with Type 1 DM estimated from published studies varies from 8% to 30%[2, 4, 6–15]. Many of these studies are not directly comparable, primarily due to differences in design.…”

Recurrent Miscarriage

“…117 ' 118 There is also a relationship between decreased serum maternal magnesium levels and spontaneous abortion among diabetic mothers. 119 The mechanism by which diabetes induces pregnancy loss is yet to be defined. Hyperglycemia is thought to be the major, but not the sole, cause of increased miscarriage.…”

Differential proteomics of placentas reveals metabolic disturbance and oxidative damage participate yak spontaneous miscarriage during late pregnancy

“…Occurrence rate of clinically spontaneous abortion for insulin-dependent diabetic women has been determined to be twice as frequent as for general women [ 35 ], implying that maternal saccharometabolic status plays a momentous role in pregnancy process. In the present study, AKR1B1 and HKDC1 were down-regulated in the aborted placenta tissue.…”