Pre-existing diabetes a risk factor for stillbirth, perinatal mortality

Pre-existing diabetes has been linked to threefold greater odds of stillbirth and perinatal mortality, with type 2 posing a greater threat than type1 diabetes, according to the results of the meta-analysis.

Researchers searched multiple online databases for cohort studies and randomized controlled trials wherein the association between pre-existing diabetes and stillbirth or perinatal mortality was explored or the risk factors for stillbirth and perinatal mortality in individuals with pre-existing diabetes were identified.

Heterogeneity and the risk of bias were assessed. Meta-analyses were performed using a random-effects model.

A total of 91 studies met the eligibility criteria and were included in the meta-analyses. Pooled data showed that pre-existing diabetes was associated with more than threefold greater odds of stillbirth (odds ratio [OR], 3.74, 95 percent confidence interval [CI], 3.17–4.41, I2=82.5 percent; 37 studies) and perinatal mortality (OR, 3.22, 95 percent CI, 2.54–4.07, I2=82.7 percent; 14 studies).

Compared with individuals with type 2 diabetes, those with type 1 diabetes had lower odds of both stillbirth (OR, 0.81, 95 percent CI, 0.68–0.95, I2=0 percent) and perinatal mortality (OR, 0.73, 95 percent CI, 0.61–0.87, I2=0 percent).

Prenatal care and prepregnancy diabetes care had a significant protective effect on the odds of stillbirth (OR, 0.26, 95 percent CI, 0.11–0.62, I2=87.0 percent) and perinatal mortality (OR, 0.41, 95 percent CI, 0.29–0.59, I2=0 percent).