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From Weston-Super-Mare, North Somerset, United Kingdom:

My partner and I recently had a stillborn baby at 35 weeks of the pregnancy. We were advised that there was no reason from the postmortem and my A1cs throughout the pregnancy were perfect. They believe that the reason is that I just plainly have diabetes and it is one of the complications of type 1 diabetes and they do not understand why this happens. We are terrified that this will happen again. Do you know any statistics of it happening a second time or even the statistics of it happening compared to non-diabetic mothers? Do you know of any studies of why this could of happened?


The fetal death rate (babies that die before delivery) is about 3/1000. About 25% of fetal deaths remain unexplained. The rest are due to chromosomal abnormalities, fetal structural defects, maternal medical problems, and problems with the placenta leading to poor growth or hypoxia. Type 1 diabetes accounts for about 1 to 5% of fetal deaths. Historically, diabetes was associated with a very high stillbirth rate. However, with the advent of good fetal surveillance, this was reduced to almost that seen in a mother without diabetes. Nevertheless, the rate is not zero. It is difficult to predict the recurrence risk, but I would conjecture that your risk is probably less than 1%. In other words, without an identified specific cause, other than the diabetes, it is unlikely to happen again. But, since it has happened once, your risk is probably slightly higher than someone else in your same position. In a future pregnancy, it will be important to apply close surveillance in the later part of the pregnancy (fetal movement assessment, non-stress testing and/or biophysical profiles). Your doctor may even offer you early delivery, although I do think this is always indicated.


Original posting 21 Oct 2004
Posted to Other and Family Planning


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