Pregnancy is associated with several complications and stillbirth is a nightmare for every expecting mother. It could happen due to several physical and medical reasons, including unhealthy lifestyle and late-term delivery. One of the most common reasons for stillbirths is pregnancy with diabetes.

The risk of stillbirth is four to five times higher in women with diabetes compared to those who don’t have this illness. Even without any kind of extra health issues, the risk factor has stubbornly remained high though there is a decline in the stillbirth rates among the general population, according to a study.

The study published in the medical journal Diabetologia earlier this week stated that obesity and high blood sugar are likely to increase the risk of stillbirth in pregnant women with diabetes.

The research focussed on the various risk factors associated with stillbirth in expecting mothers with diabetes. According to it, expecting mothers are more likely to experience stillbirth due to poorly or uncontrolled blood glucose levels and body mass index (BMI) if they have diabetes.

For the study, the researchers analyzed the data of expecting mothers with high blood glucose levels who delivered their babies in Scotland between 1998 and 2016. The information for the research was collected from Scottish Care Information-Diabetes and Scottish Morbidity Record 02.

After analyzing the data, the researchers found that most of the stillbirths occurred during preterm gestation, one-third of it happened during full-term pregnancy. The stillbirth rates were 39 for every 1,000 deliveries. While the rates for deliveries with type 2 diabetes were 22.9, they were 16.1 for type 1 diabetes.

“The question has to be asked whether earlier delivery of diabetic pregnancies could prevent these term stillbirths, but we don’t know the answer to this. The optimal timing of delivery in pregnancy complicated by diabetes is not clear,” lead researcher Sharon Mackin, who is a researcher at the University of Glasgow in Scotland, told Reuters.

The mothers with both types of diabetes were more likely to experience stillbirth if the infants were much larger than their gestational age, the study stated. The research also stated that women with type 1 diabetes were at highest risk of stillbirth if their infants were smaller than the gestational age.

Though the study has its limitations due to the dramatic change in diabetes treatment during the study period, the researchers concluded by stating that BMI and maternal glucose levels can be modified during pregnancy to reduce the risks associated with stillbirth.

The researchers also said premature babies born to women with diabetes are likely to struggle with breathing problems, mainly because of immature lung development. “The risk of such breathing problems is higher in the 37th week than at later weeks. I think this is a key area of research that needs to be explored further before any further recommendations can be made to changing routine delivery care for these women,” Mackin said.