Fetal loss and maternal glucose intolerance. A retrospective study

The premise that unexplained fetal loss is associated with maternal intravenous glucose intolerance (IVGT) has been studied retrospectively in three pregnancy related groups. In 97 women (Group A) who had stillbirths inadequately explained by obstetrical or necropsy findings, 24 per cent had abnormal IVGT tested six weeks postpartum. In 115 women (Group B) with histories of two or more spontaneous abortions (recurrent abortion) tested late in a subsequent successful pregnancy 26 per cent were abnormal. In 465 pregnancies of women with abnormal IVGT diagnosed during pregnancy (Group C) there were 19 perinatal deaths (12 stillbirths and 7 first week deaths) (Perinatal Mortality Rate 41 per 1000). Perinatal mortality characteristics which are similar to those found in insulin dependent diabetes namely a high incidence of major fetal abnormality (37 per cent) and the occurrence of hyaline membrane disease in term infants were observed. A causal association is postulated between inadequately explained stillbirth and recurrent abortion and abnormal maternal IVGT.