Oral antidiabetic drugs in pregnancy

Abstract

A recent report casts doubt on the safety of oral antidiabetic drugs in pregnancy by suggesting that chlorpropamide (Diabinese - Pfizer), in high doses is associated with a high perinatal mortality (Brit. med. J. 1963, 1, 59). Out of 19 diabetic mothers who received 500 mg of the drug daily, 14 (74%) had perinatal loss. It is not clear whether this is due to inadequate diabetic control or to some direct effect of the chlorpropamide. Confirmation of these results is desirable and more information about the effects of other antidiabetic sulphonylurea derivatives in pregnancy (for example, tolbutamide) is also needed. There is little evidence that oral antidiabetic drugs induce congenital abnormalities in the human foetus, although cases have been reported (Lancet 1960, 2, 1424; 1961, 1, 891). The British manufacturers of oral antidiabetic drugs warn against their use in pregnancy.