[Role of glycemic control and incidence of spontaneous abortions pregnant in women with type 1 diabetes mellitus].

UNLABELLED: Pregnant women with diabetes mellitus type 1 and poor metabolic control are with high frequency of spontaneous abortion.

PURPOSE: To determine the correlation between the poor glycaemic control of diabetes in early pregnancy and the risk of spontaneous abortion.

DESIGN OF STUDY: A prospective study over 116 women with type 1 diabetes mellitus who have been hospitalized in SHATOG "Maichin dom" during the period: January 1998-January 2004 have been done. The pregnant women have been divided in two groups. Pregnant women with pre-planned pregnancy n = 44 and pregnant women with unplanned pregnancy n = 72. The levels of pre- and postprandial blood glucose and those of glycosylated hemoglobin Hb A1c at first trimester have been measured.

RESULTS: In 20 of all pregnant women (17.2%) spontaneous abortion have been observed. In those women with abortion the initial glycaemia has been significantly higher-preprandial glucose is 10.2 +/- 3.4 mmol/l and postprandial glucose is 12.2 +/- 4.2 mmol/l in contrast to those in women without abortions--preprandial glucose 6.6 +/- 1 mmol/l postprandial glucose is 7.9 +/- 1.9 mmol/l. The mean values of Hb A1c at first trimester have been higher in those women with abortions--10.1% +/- 1.5 in contrast to those without abortions 7.0% +/- 0.7.

CONCLUSION: The pregnant women with diabetes type 1 and higher initial levels of blood glucose and glycosylated hemoglobin in the first trimester of pregnancy have a higher risk of spontaneous abortions. The rate of spontaneous abortions in diabetic women with pre-planned pregnancy and optimized metabolic control before conception is lower.