DIABETES AND PREGNANCY: WITH SPECIAL REFERENCE TO THE PREDIABETIC STATE

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Abstract
The obstetrical records of 72 diabetic women were analyzed. In 402 pregnancies that occurred prior to the onset of clinical diabetes, the fetal mortality rate was 23.8%; in 24 after the diagnosis of diabetes, it was 45.9%. In 18 cases in which diabetes was diagnosed during pregnancy, it was 66.7%. There were no fetal deaths in 6 diabetic patients who received diethylstilbestrol during pregnancy. The pregnancies were complicated by large babies, toxemia, stillbirths, neonatal deaths, spontaneous abortions, and poly-hydramnios. The incidence of these complications in the pre-diabetic women increased as the interval between the pregnancy and the onset of clinical diabetes decreased. The factor or factors that cause complications act for many years before these women develop clinical diabetes. The onset of diabetes may often be predicted from a carefully taken pregnancy history, and many cases of mild diabetes could be detected by the use of more careful screening methods. Obstetricians should be careful to routinely check postprandial rather than fasting urine specimens for sugar. All women with glycosuria, obesity, a family history of diabetes or complications of pregnancy should have a 3 hour glucose tolerance test.