Periconceptional metabolic status and risk for spontaneous abortion in insulin-dependent diabetic pregnancies

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.