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22.05.2023

The Impact of New and Renewed Restrictive State Abortion Laws on Pregnancy-Capable People with Diabetes

verfasst von: Ajleeta Sangtani, Lauren Owens, David T. Broome, Preethi Gogineni, William H. Herman, Lisa H. Harris, Lauren Oshman

Erschienen in: Current Diabetes Reports | Ausgabe 8/2023

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Abstract

Purpose of Review

When the Supreme Court handed down its decision in Dobbs v Jackson Women’s Health Organization in June 2022, the constitutional right to abortion was no longer protected by Roe v Wade. Fifteen states now have total or near-total bans on abortion care or no clinics providing abortion services. We review how these restrictions affect the medical care of people with pregestational diabetes.

Recent Findings

Of the ten states with the highest percent of adult women living with diabetes, eight currently have complete or 6-week abortion bans. People with diabetes are at high risk of diabetes-related pregnancy complications and pregnancy-related diabetes complications and are disproportionately burdened by abortion bans.

Summary

Abortion is an essential part of comprehensive, evidence-based diabetes care, yet no medical society has published guidelines on pregestational diabetes that explicitly discuss the importance and role of safe abortion care. Medical societies enacting standards for diabetes care and clinicians providing diabetes care must advocate for access to abortion to reduce pregnancy-related morbidity and mortality for pregnant people with diabetes.

Azeez O, Kulkarni A, Kuklina EV, Kim SY, Cox S. Hypertension and diabetes in non-pregnant women of reproductive age in the United States. Prev Chronic Dis. 2019;24(16):E146. https://doi.org/10.5888/pcd16.190105.CrossRef

Prevalence of both diagnosed and undiagnosed diabetes: Centers for Disease Control and Prevention; 2022 [Available from: https://www.cdc.gov/diabetes/data/statistics-report/diagnosed-undiagnosed-diabetes.html.

Moseson H, Zazanis N, Goldberg E, Fix L, Durden M, Stoeffler A, et al. El imperativo de incluir los géneros no binario y transgénero. Obstet Gynecol. 2020;135:1059–68.PubMedPubMedCentralCrossRef

Knorr S, Juul S, Bytoft B, Lohse Z, Clausen TD, Jensen RB, et al. Impact of type 1 diabetes on maternal long-term risk of hospitalisation and mortality: a nationwide combined clinical and register-based cohort study (The EPICOM study). Diabetologia. 2018;61:1071–80.PubMedCrossRef

Gordon MC, Landon MB, Boyle J, Stewart KS, Gabbe SG. Coronary artery disease in insulin-dependent diabetes mellitus of pregnancy (class H): a review of the literature. Obstet Gynecol Surv. 1996;51(7):437–44.PubMedCrossRef

Wang S, Rexrode KM, Florio AA, Rich-Edwards JW, Chavarro JE. Maternal mortality in the United States: trends and opportunities for prevention. Annu Rev Med. 2023;74:199–216.PubMedCrossRef

Hawthorne G. Maternal complications in diabetic pregnancy. Best Pract Res Clin Obstet Gynaecol. 2011;25(1):77–90.PubMedCrossRef

Pregestational diabetes mellitus. Obstet Gynecol. 2018;132(6):e228–48.CrossRef

Common eye disorders and diseases. Centers for Disease Control and Prevention. 2020.

10.

Negrato CA, Mattar R, Gomes MB. Adverse pregnancy outcomes in women with diabetes. Diabetol Metab Syndr. 2012;4(1):1–6.CrossRef

11.

Toda J, Kato S, Sanaka M, Kitano S. The effect of pregnancy on the progression of diabetic retinopathy. Jpn J Ophthalmol. 2016;60:454–8.PubMedCrossRef

12.

Diep TM, Tsui I. Risk factors associated with diabetic macular edema. Diabetes Res Clin Pract. 2013;100(3):298–305.PubMedCrossRef

13.

Sinclair SH, Nesler C, Foxman B, Nichols CW, Gabbe S. Macular edema and pregnancy in insulin-dependent diabetes. Am J Ophthalmol. 1984;97(2):154–67.PubMedCrossRef

14.

Mallika P, Tan A, Aziz S, Asok T, Alwi SS, Intan G. Diabetic retinopathy and the effect of pregnancy. Malays Fam Phys. 2010;5(1):2.

15.

Gordin D, Kaaja R, Forsblom C, Hiilesmaa V, Teramo K, Groop P-H. Pre-eclampsia and pregnancy-induced hypertension are associated with severe diabetic retinopathy in type 1 diabetes later in life. Acta Diabetol. 2013;50(5):781–7.PubMedCrossRef

16.

Bramham K. Diabetic Nephropathy and Pregnancy. Semin Nephrol. 2017;37(4):362–9.PubMedCrossRef

17.

Spotti D. Pregnancy in women with diabetic nephropathy. J Nephrol. 2019;32(3):379–88.PubMedCrossRef

18.

Sibai BM, Viteri OA. Diabetic ketoacidosis in pregnancy. Obstet Gynecol. 2014;123(1):167–78.PubMedCrossRef

19.

Inkster ME, Fahey TP, Donnan PT, Leese GP, Mires GJ, Murphy DJ. Poor glycated haemoglobin control and adverse pregnancy outcomes in type 1 and type 2 diabetes mellitus: systematic review of observational studies. BMC Pregnancy Childbirth. 2006;6(1):1–13.CrossRef

20.

Ornoy A, Becker M, Weinstein-Fudim L, Ergaz Z. Diabetes during pregnancy a maternal disease complicating the course of pregnancy with long-term deleterious effects on the offspring. a clinical review. Int J Mol Sci. 2021;22(6):2965.PubMedPubMedCentralCrossRef

21.

Greene MF. Spontaneous Abortions and Major Malformations in Women with Diabetes Mellitus. Semin Reprod Endocrinol. 1999;17(2):127–36.PubMedCrossRef

22.

Rosa F, Bosco L. Infant renal failure with maternal ACE inhibition. Am J Obstet Gynecol. 1991;164:273.CrossRef

23.

Ralph L, Foster DG, Raifman S, Biggs MA, Samari G, Upadhyay U, et al. Prevalence of self-managed abortion among women of reproductive age in the United States. JAMA Network Open. 2020;3(12):e2029245-e.CrossRef

24.

Jesmin S, Jahan S, Khan M, Sultana N, Jerin J, Habib S, et al. The incidence, predisposing factors, complications and outcome of preeclampsia in diabetic pregnancy. BIRDEM Med J. 2011;1(1):10–4.CrossRef

25.

Davidson AJ, Park AL, Berger H, Aoyama K, Harel Z, Cook JL, et al. Risk of severe maternal morbidity or death in relation to elevated hemoglobin A1c preconception, and in early pregnancy: a population-based cohort study. PLoS Med. 2020;17(5):e1003104.PubMedPubMedCentralCrossRef

26.

Shah NS, Wang MC, Freaney PM, Perak AM, Carnethon MR, Kandula NR, et al. Trends in gestational diabetes at first live birth by race and ethnicity in the US, 2011–2019. JAMA. 2021;326(7):660–9.PubMedPubMedCentralCrossRef

27.

Oettle H, Neuhaus P, Hochhaus A, Hartmann JT, Gellert K, Ridwelski K, et al. Adjuvant chemotherapy with gemcitabine and long-term outcomes among patients with resected pancreatic cancer: the CONKO-001 randomized trial. JAMA. 2013;310(14):1473–81.PubMedCrossRef

28.

Vounzoulaki E, Khunti K, Abner SC, Tan BK, Davies MJ, Gillies CL. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. BMJ. 2020;369:m1361.

29.

Yang G-R, Dye TD, Li D. Effects of pre-gestational diabetes mellitus and gestational diabetes mellitus on macrosomia and birth defects in upstate New York. Diabetes Res Clin Pract. 2019;155:107811.PubMedPubMedCentralCrossRef

30.

Malaza N, Masete M, Adam S, Dias S, Nyawo T, Pheiffer C. A systematic review to compare adverse pregnancy outcomes in women with pregestational diabetes and gestational diabetes. Int J Environ Res Public Health. 2022;19(17):10846.PubMedPubMedCentralCrossRef

31.

Jones RK, Kirstein M, Philbin J. Abortion incidence and service availability in the United States. Perspect Sex Reprod Health. 2022;54(4):128–41.PubMedPubMedCentralCrossRef

32.

Jatlaoui C, Eckhaus L, Mandel MG, Nguyen A, Oduyebo T, Petersen E, et al. Abortion surveillance—United States, 2016. Morb Mortal Wkly Rep Recomm Rep. 2019;68(11):1–41.

33.

World Health Organization. Abortion care guideline. World Health Organization. 2022.

34.

Federation, National Abortion. Clinical policy guidelines for abortion Care. 2020.

35.

Food US, Drug Administration, and Others. Mifeprex (mifepristone) tablets label. 2016.

36.

Harris LH, Grossman D. Complications of unsafe and self-managed abortion. N Engl J Med. 2020;382(11):1029–40.PubMedCrossRef

37.

Henkel A, Blumenthal PD. Second-trimester abortion care for those with complex medical conditions. Curr Opin Obstet Gynecol. 2022;34(6):359–66.PubMedCrossRef

38.

Guiahi M, Davis A. First-trimester abortion in women with medical conditions. Contraception. 2012;86(6):622–30.PubMedCrossRef

39.

Grossman D, Blanchard K, Blumenthal P. Complications after second trimester surgical and medical abortion. Reprod Health Matters. 2008;16(sup31):173–82.PubMedCrossRef

40.

Jones RK, Jerman J. Population group abortion rates and lifetime incidence of abortion: United States, 2008–2014. Am J Public Health. 2022;112(9):1284–96.PubMedCrossRef

41.

Sjöberg L, Kaaja R, Gissler M, Tuomilehto J, Tiitinen A, Pitkäniemi J. Termination of pregnancy and sterilisation in women with childhood-onset type 1 diabetes. Diabetologia. 2017;60:2377–83.PubMedPubMedCentralCrossRef

42.

Raymond EG, Grimes DA. The comparative safety of legal induced abortion and childbirth in the United States. Obstet Gynecol. 2012;119(2 Part 1):215–9.PubMedCrossRef

43.

DiCenzo N. Unclear language of abortion ban exceptions risks patient health: health affairs; 2022 [Available from: https://www.healthaffairs.org/content/forefront/unclear-language-abortion-ban-exceptions-risks-patient-health.

44.

Human Life Protection Act, RS 40:1061

45.

Public Health, 41–41–191. Gestational Age Act. 2019.

46.

Nash E. State Policy Trends 2022: in a devastating year, US Supreme Court’s decision to overturn roe leads to bans, confusion and chaos 2022 [Available from: https://www.guttmacher.org/2022/12/state-policy-trends-2022-devastating-year-us-supreme-courts-decision-overturn-roe-leads.

47.

KFF analysis of state policies and court decision 2023 [Available from: https://www.kff.org/womens-health-policy/dashboard/abortion-in-the-u-s-dashboard/.

48.

State Population Totals and Components of Change: 2020-2022: United States Census Bureau; 2022 [Available from: https://www.census.gov/data/tables/time-series/demo/popest/2020s-state-total.html.

49.

Rudowitz R. After roe: options to address medicaid coverage policy related to maternal and child health. KFF. 2022;15:2022.

50.

Dehlendorf C, Rodriguez MI, Levy K, Borrero S, Steinauer J. Disparities in family planning. Am J Obstet Gynecol. 2010;202(3):214–20.PubMedPubMedCentralCrossRef

51.

Percentage of adults with diagnosed diabetes by age group: Centers for Disease Control and Prevention (CDC) National Diabetes Surveillance System Diabetes Atlas; 2022 [Available from: https://www.kff.org/other/state-indicator/adults-with-diabetes-by-age/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Total%20(Age-Adjusted)%22,%22sort%22:%22desc%22%7D.

52.

Ray JG, O’brien TE, Chan WS. Preconception care and the risk of congenital anomalies in the offspring of women with diabetes mellitus a meta-analysis. Qjm. 2001;94(8):435–44.PubMedCrossRef

53.

Management of diabetes in pregnancy. standards of medical care in diabetes—2022. Diabetes Care. 2022;45(Supplement_1):S232–43.CrossRef

54.

Guerin A, Nisenbaum R, Ray JG. Use of maternal GHb concentration to estimate the risk of congenital anomalies in the offspring of women with prepregnancy diabetes. Diabetes Care. 2007;30(7):1920–5.PubMedCrossRef

55.

Jensen DM, Korsholm L, Ovesen P, Beck-Nielsen H, Moelsted-Pedersen L, Westergaard JG, et al. Peri-conceptional A1C and risk of serious adverse pregnancy outcome in 933 women with type 1 diabetes. Diabetes Care. 2009;32(6):1046–8.PubMedPubMedCentralCrossRef

56.

Nielsen GL, Møller M, Sørensen HT. HbA1c in early diabetic pregnancy and pregnancy outcomes: a Danish population-based cohort study of 573 pregnancies in women with type 1 diabetes. Diabetes Care. 2006;29(12):2612–6.PubMedCrossRef

57.

Finer LB, Zolna MR. Declines in unintended pregnancy in the United States, 2008–2011. N Engl J Med. 2016;374(9):843–52.PubMedPubMedCentralCrossRef

58.

Kitzmiller JL, Ferrara A, Peng T, Cissell MA, Kim C. Preexisting diabetes and pregnancy. In: Cowie CC, Casagrande SS, Menke A, Cissell MA, Eberhardt MS, Meigs JB, Gregg EW et al. Bethesda (MD) (eds) Diabetes in America : National Institute of Diabetes and Digestive and Kidney Diseases (US). n.d.

59.

Unintended Pregnancy in the United States: Guttmacher Institute; 2019 [Available from: https://www.guttmacher.org/fact-sheet/unintended-pregnancy-united-states.

60.

By the Numbers: Diabetes in America: Centers for Disease Control and Prevention; 2022 [Available from: https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html.

61.

Disability and Diabetes Prevention: Centers for Disease Control and Prevention; 2022 [Available from: https://www.cdc.gov/ncbddd/disabilityandhealth/features/disability-and-diabetes-prevention.html.

62.

Jackson AV, Wang L-F, Morse J, editors. Racial and ethnic differences in contraception use and obstetric outcomes: a review. Seminars in perinatology; 2017: Elsevier.

63.

Advancing Health Equity: Centers for Disease Control and Prevention; 2022 [Available from: https://www.cdc.gov/diabetes/health-equity/index.html.

64.

Aiken A, Lohr PA, Lord J, Ghosh N, Starling J. Effectiveness, safety and acceptability of no-test medical abortion (termination of pregnancy) provided via telemedicine a national cohort study. BJOG An Int J Obstet Gynaecol. 2021;128(9):1464–74.CrossRef

65.

Rader B, Upadhyay UD, Sehgal NK, Reis BY, Brownstein JS, Hswen Y. Estimated travel time and spatial access to abortion facilities in the US before and after the Dobbs v Jackson women’s health decision. JAMA. 2022;328(20):2041–7.PubMedPubMedCentralCrossRef

66.

Yehuda I. Implementation of preconception care for women with diabetes. Diabetes Spectr. 2016;29(2):105.PubMedPubMedCentralCrossRef

67.

Dimes. Nowhere to go: Maternity care deserts across the US. 2018.

68.

Meregaglia M, Dainelli L, Banks H, Benedetto C, Detzel P, Fattore G. The short-term economic burden of gestational diabetes mellitus in Italy. BMC Pregnancy Childbirth. 2018;18(1):1–9.CrossRef

69.

Preface & Preamble: AMA; [Available from: https://code-medical-ethics.ama-assn.org/preface-preamble.

70.

Reingold RB, Gostin LO, Goodwin MB. Legal risks and ethical dilemmas for clinicians in the aftermath of Dobbs. JAMA. 2022;328(17):1695–6.PubMedCrossRef

71.

Peek ME. By any means necessary: why lowering insulin prices is relevant to racial health equity. Lancet (London, England). 2021;398(10313):1783.PubMedCrossRef

72.

Levy MS, Fishbach S, Salles A, Arora VM. When do medical societies take a stand on abortion? J Gen Intern Med. 2023;38(6):1559–62.

73.

Caughey AB, Kaimal AJ, Gabbe SG. ACOG PRACTICE BULLETIN NUMBER 201 Pregestational diabetes mellitus. Obstet Gynecol. 2018;132(6):E228–48.CrossRef

74.

Ferketa M, Schueler K, Song B, Carlock F, Stulberg DB, White VE. Facilitators of and barriers to successful implementation of the one key question® pregnancy intention screening tool. Women’s Health Reports. 2022;3(1):326–34.PubMedPubMedCentralCrossRef

75.

Callegari LS, Aiken AR, Dehlendorf C, Cason P, Borrero S. Addressing potential pitfalls of reproductive life planning with patient-centered counseling. Am J Obstet Gynecol. 2017;216(2):129–34.PubMedCrossRef

76.

BirruTalabi M, Callegari LS, Kazmerski TM, Krishnamurti T, Mosley EA, Borrero S. A blueprint for a new model of sexual and reproductive health care in subspecialty medicine. Health Serv Res. 2023;58(1):216–22.CrossRef

77.

Rasmussen B, Hendrieckx C, Clarke B, Botti M, Dunning T, Jenkins A, et al. Psychosocial issues of women with type 1 diabetes transitioning to motherhood: a structured literature review. BMC Pregnancy Childbirth. 2013;13(1):1–10.CrossRef

78.

Blonde L, Umpierrez GE, Reddy SS, McGill JB, Berga SL, Bush M, Chandrasekaran S et al. American association of clinical endocrinology clinical practice guideline: developing a diabetes mellitus comprehensive care plan—2022 Update. Endocrine Practice: Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2022;28(10):923–1049.

79.

Blumer I, Hadar E, Hadden DR, Jovanovič L, Mestman JH, Murad MH, et al. Diabetes and pregnancy: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2013;98(11):4227–49.PubMedPubMedCentralCrossRef

80.

Dickman SL, White K, Grossman D. Affordability and access to abortion care in the United States. JAMA Intern Med. 2021;181(9):1157–8.PubMedCrossRef

81.

Biggs MA, Gould H, Foster DG. Understanding why women seek abortions in the US. BMC Womens Health. 2013;13(1):1–13.CrossRef

82.

Martis R, Brown J, McAra-Couper J, Crowther CA. Enablers and barriers for women with gestational diabetes mellitus to achieve optimal glycaemic control–a qualitative study using the theoretical domains framework. BMC Pregnancy Childbirth. 2018;18(1):1–22.CrossRef

83.

Hassan A, Yates L, Hing AK, Hirz AE, Hardeman R. Dobbs and disability: implications of abortion restrictions for people with chronic health conditions. Health Serv Res. 2023;58(1):197.PubMedCrossRef

84.

Ross L, Solinger R. Reproductive Justice: An Introduction. Univ of California Press. 2017.

85.

Crear-Perry J, Hassan A, Daniel S. Advancing birth equity in a post-Dobbs US. JAMA. 2022;328(17):1689–90.PubMedCrossRef

Titel: The Impact of New and Renewed Restrictive State Abortion Laws on Pregnancy-Capable People with Diabetes
verfasst von: Ajleeta Sangtani
Lauren Owens
David T. Broome
Preethi Gogineni
William H. Herman
Lisa H. Harris
Lauren Oshman
Publikationsdatum: 22.05.2023
Verlag: Springer US
Erschienen in: Current Diabetes Reports / Ausgabe 8/2023
Print ISSN: 1534-4827
Elektronische ISSN: 1539-0829
DOI: https://doi.org/10.1007/s11892-023-01512-4

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The Impact of New and Renewed Restrictive State Abortion Laws on Pregnancy-Capable People with Diabetes

Abstract

Purpose of Review

Recent Findings

Summary

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Abstract

Purpose of Review

Recent Findings

Summary

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Battle of Experts: Sport vs. Spritze bei Adipositas und Typ-2-Diabetes

Triglyzeridsenker schützt nicht nur Hochrisikopatienten

Gibt es eine Wende bei den bioresorbierbaren Gefäßstützen?

Vorsicht, erhöhte Blutungsgefahr nach PCI!

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