For a study, researchers sought to describe stillbirths related to pregestational diabetes and gestational diabetes mellitus (GDM) in a large, prospective case-control research conducted in the United States. A secondary analysis of stillbirths was undertaken among patients recruited in a prospective, multisite, geographically, racially, and ethnically diverse case-control research in the United States. Singleton pregnancies with comprehensive diabetes status information and a complete postmortem examination were included. A conventional stillbirth evaluation process included postmortem evaluation, placental pathology, clinical testing at the discretion of the health care practitioner, and a suggested panel of tests. Stillbirth cases were assigned a possible cause of death using a standardized categorization technique. Demographic and delivery features of women with pregestational diabetes and gestational diabetes were compared to characteristics of women without diabetes in pairwise comparisons using 2 or two-sample t-tests, if applicable. Pregnancies with genetic disorders or significant fetal abnormalities were excluded from the sensitivity analysis.

Women with stillbirth and diabetes were more likely to be older than 35 years and have a higher body mass index, according to the primary study of 455 stillbirth cases. They were also more likely than nondiabetic women to suffer a gestational hypertension condition (28% vs 9.1%; P<.001). Pregnant women had higher large-for-gestational-age (LGA) neonates (26% vs 3.4%; P<.001). Pregnant women with pregestational diabetes (36%) had higher stillbirths than those with gestational diabetes (GDM) (52%). Maternal medical problems, such as pregestational diabetes and others, were more frequently recognized as a likely or plausible cause of death in stillbirths with maternal diabetes (43% vs 4%, P<.001) than in stillbirths without diabetes (43% vs 4%, P<.001).

Stillbirths in women with pregestational diabetes and GDM occurred later in pregnancy than in women without diabetes and were related to hypertensive disorders of pregnancy, maternal medical problems, and LGA.

Reference:https://journals.lww.com/greenjournal/Abstract/2020/12000/Characteristics_of_Stillbirths_Associated_With.6.aspx