Diabetes and pregnancy risks

Women with type 1 diabetes

Risks to your baby

Diabetes can increase the risk of birth defects (congenital abnormalities) in babies. These abnormalities are more common when the diabetes management before and during early pregnancy has not been optimal.

Damage to the baby's heart, spine and kidneys can occur during the early stages of pregnancy, often before women realise they are pregnant. Miscarriage can also occur, as it can for all women.

The first eight weeks of pregnancy is the time when a baby’s major organs develop, so it is important for your blood glucose levels to be as close to target as possible when you conceive and in the first part of your pregnancy.

This reduces the risk of health problems in the developing baby and the chances of an early miscarriage. The risk of miscarriage increases when HbA1c is elevated before falling pregnant and in the early stages of pregnancy. 

Reducing the risk

To reduce your chance of miscarriage and of your baby developing abnormalities, it is important to maintain the best diabetes management you can.

Your diabetes in pregnancy team will stress the importance of frequently checking your blood glucose levels and keeping these as close to the target range as possible. It is also important to minimise the frequency of mild hypos and the risk of serious hypos, and to try and limit the swings in your glucose levels. Talk to your diabetes in pregnancy team about your individual blood glucose targets.

The aim is to have your HbA1c less than 7% (53mmol/mol), if possible for three months before falling pregnant. Your diabetes in pregnancy team can advise you on your personal HbA1c goal before you conceive. Have your blood glucose meter checked and upgraded, if necessary, to make sure your blood glucose readings are accurate. 

Along with your own efforts to achieve target blood glucose levels, pregnancy-related changes will also cause a drop in your HbA1c. The recommended HbA1c during pregnancy is 6% or lower, but this should be discussed with your diabetes team.