Spontaneous abortion and diabetes mellitus

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Reproductive Medicine

Background:

• Insulin-dependent diabetes in pregnancy presents significant risks.
• Glycosylated hemoglobin (HbA1c) reflects long-term glycemic control.
• Early pregnancy glycemic control is critical for fetal development.

Purpose of the Study:

• To investigate the correlation between glycosylated hemoglobin levels and spontaneous abortion rates in insulin-dependent diabetic pregnancies.
• To highlight the importance of glycemic control in the first trimester.

Main Methods:

• Prospective study of 58 insulin-dependent diabetic pregnancies.
• Measurement of glycosylated hemoglobin (HbA1c) at booking for antenatal care.
• Comparison of HbA1c levels between women with spontaneous abortion and successful delivery.

Main Results:

• 78% of women had elevated HbA1c at booking.
• 15 pregnancies resulted in spontaneous abortion, with 10 occurring before 15 weeks' gestation.
• Significantly higher HbA1c levels were observed in women who experienced spontaneous abortion compared to those with successful delivery (12.8% vs. 11.2%).

Conclusions:

• Elevated first-trimester glycosylated hemoglobin levels are associated with an increased risk of spontaneous abortion in insulin-dependent diabetic pregnancies.
• Intensified diabetic management and achieving optimal glycemic control early in pregnancy are essential for improving pregnancy outcomes.