Pregnancy loss in patients with type 1 or type 2 diabetes during pregnancy

Anita McGrogan, Julia Snowball, Corinne De Vries

Research output: Contribution to journalArticle

Abstract

Background: Prevalence in women of child‐bearing age is around 0.7% for type 1 diabetes (DM1) and 0.4% for type 2 diabetes (DM2). There is uncertainty about the magnitude of risk of pregnancy loss associated with DM.

Objectives: To establish the rate of pregnancy loss in patients with type 1 (DM1) and type 2 (DM2) diabetes.

Methods: Patients with DM1 or DM2 diagnosed before pregnancy were identified on the UK General Practice Research Database (GPRD) by identifying records of medical diagnoses, prescribing, relevant referrals and the use of home monitoring equipment. The study period was from January 1992 until March 2007. Pregnancy outcomes were determined as being pregnancy loss or delivery. Pregnancy loss was categorised as spontaneous, induced or unknown, depending on the evidence available in the medical records.

Results: Of 669 322 pregnancies identified, 1979 were affected by DM1 and 720 by DM2. In those with DM1, 615 (31.1%) pregnancies ended in a loss in the 1st trimester and 37 (1.9%) in the 2nd trimester. In patients with DM2, there were 252 (35%) pregnancy losses in the first and 17 (2.4%) in the second trimester. Overall, for DM1 and DM2 54.4% of all the pregnancy losses that occurred were spontaneous; 23.3% were induced (11 for medical reasons, 124 for non‐medical reasons and 80 for unknown reasons); 10 pregnancies were recorded as ectopic, two as hydatidiform mole and the remaining 193 were losses where the reason could not be determined (21.0%). Of all pregnancies therefore, 18% in DM1 and 20.1% in DM2 resulted in a spontaneous loss, which is more than reported previously.

Conclusions: A higher rate of spontaneous pregnancy loss was found in patients with DM1 and DM2 compared with previous studies. It is possible that previous studies have underestimated spontaneous pregnancy loss because the data sources used did not capture all trimester 1 losses.
Original languageEnglish
Article number498
Pages (from-to)S211
JournalPharmacoepidemiology and Drug Safety
Volume19
Issue numberS1
DOIs
Publication statusPublished - 2010
Event26th International Conference on Pharmacoepidemiology & Therapeutic Risk Management - Brighton, UK United Kingdom
Duration: 19 Aug 201022 Aug 2010

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