Preexisting Diabetes Mellitus and Adverse Pregnancy Outcomes

Abstract

Introduction: Preexisting diabetes increases the risk for unwanted pregnancy outcomes. Aim: To describe and record
the existing knowledge about these unwanted outcomes. Material and Methods: PubMed and Google Scholar were
searched for recent literature. Results: Preexisting type 1 and type 2 diabetes has been associated with an increased risk
for complications, both for mothers and infants. To a great extent, these problems are due to the pathophysiology of
diabetes and specifically to the effects of glycated hemoglobin on fetal development and maternal health. Congenital
anomalies and preeclampsia are the most common complications. Pregnancies with pre-existing diabetes also have a high risk for preterm delivery and macrosomia, with concomitants injury events such as shoulder dystocia with
vaginal delivery; this can affect rates caesarean section. Other unwanted outcomes include miscarriage and stillbirth,
a higher incidence of respiratory distress, polycythemia, hypoglycemia, and hyperbilirubinemia compared to infants of
mothers without diabetes. Finally, postpartum depression is also a possibility for diabetics mothers that just gave birth.
Conclusions: Providing optimal care for diabetic pregnant women can be crucial to minimize many complications,
including prematurity, miscarriage, stillbirth, macrosomia and subsequent complications of childbirth. Future research
may contribute to understanding the risk factors in terms of how they affect pregnancy and how they interact. The
findings can be used to improve disease management through the design of protocols.