Prevalence of abortion in diabetic women in Kuwait

ABSTRACT

To evaluate the spontaneous abortion incidence in pregnant women with subtypes of diabetes in Kuwait and to evaluate their associations with suspected risk factors. Data of 356 pregnant women with type 1, type 2 and gestational diabetes mellitus was recorded from the Al Sabah Maternity Hospital in Kuwait in the period from 2002-2005. Maternal, past obstetrical and diabetic information was recorded. There were 356 pregnancies, 104 [28.4%] occurred in type 1 diabetes mellitus [T1 DM], 170 [47.8%] in type 2 diabetes mellitus [T2 DM] and 85 [23.9%] in gestational diabetes mellitus, [0DM]. The age, body mass index [BMI], nationality, number of previous abortions, number of previous pregnancies, duration and family history of diabetes, and details of anti diabetic treatments, especially of the aborted group were analyzed. We observed 15 abortions [15%], 67[64%] and 22[21%] in type 1, T2 and GDM respectively. Pregnant women with T1 DM were younger, leaner, more often primigravida, and has less abortion rates than T2 DM women or 0DM. Overall, the majority of pregnancies were multipara [p=0.015]. Glycated hemoglobin [HbAlc] levels were significantly higher in the aborted women with T2 DM; 76% spontaneous abortion occurred with HbAlc levels<7.61% with levels from 7-8, and 61% with levels from 8-10 [p=0.020]. Of the 104 aborted women, half of the T2 DM [51%] and nearly one third of the, GDM [28%] were insulin treated during their pregnancy. Our preliminary study indicates a significant and consistent relationship between spontaneous abortion and women with subtypes of diabetes in Kuwait. It suggested that this is due to many different risk factors but mainly to the level of glycated hemoglobin in the first trimester of pregnancies with T1, T2 and GDM. These observations are very important since maternal diabetic control can be improved before and during pregnancy and to reduced the incidence of abortion in diabetic women in Kuwait