Periconceptional metabolic status and risk for spontaneous abortion in insulin-dependent diabetic pregnancies.
The rate of clinically apparent spontaneous abortions in insulin-dependent diabetic pregnancies has been prospectively determined to be twice as frequent as for the general population (29.5% versus 10 to 15%). In a series of several successive studies, we have shown that spontaneous abortions are associated with poor metabolic control around conception and/or in the early weeks of pregnancy, but not in the 1 to 2 weeks preceding the abortive event itself. There is also a significant relationship between decreased maternal magnesium status (as assessed by maternal serum magnesium concentration) and adverse fetal outcome (spontaneous abortion and/or major congenital malformations) in insulin-dependent diabetic women. We speculate that improvement of glycemic control and of magnesium status before conception and in the very early phases of organogenesis might improve embryonic and fetal survival.
D000022:Abortion, Spontaneous / Q000209:etiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000378:metabolism; D005260:Female; D006801:Humans; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000150:complications* / Q000378:metabolism; D011446:Prospective Studies; D012189:Retrospective Studies