Bibliographic information
GuidelineWHO recommendations on care for women with diabetes during pregnancy
Year of Publication2025
Issuing InstitutionWorld Health Organization
Recommendation
New
For pregnant women with type 1 or type 2 diabetes with impaired renal function, emphasize the importance of maintaining blood pressure levels below 130/80 mmHg during pregnancy and offer antihypertensives known to be safe in pregnancy as indicated. Advise women to modify major risk factors for cardiovascular disease (e.g. smoking, unhealthy diet, sedentary behaviour) and to seek specialist postnatal follow-up.
Recommended
Notes and Remarks
Assessing pre-eclampsia risk
- The urinary albumin/creatinine ratio or protein/creatinine ratio early in pregnancy may be used as a baseline when evaluating the risk of pre-eclampsia later in pregnancy. Routine assessment
- While Recommendation 26 advises against routine renal assessment for women with GDM, this does not preclude its use in clinical contexts where its use would potentially improve outcomes, such as providing a baseline for comparison later in pregnancy during an evaluation for pre-eclampsia. Blood pressure management
- Recommendation 27 has been adapted from advice for the management of type 2 diabetes, using medications that are used for blood pressure management during pregnancy. The WHO guideline on the treatment of non-severe hypertension in pregnancy suggests consideration of oral alpha-agonist (methyldopa) and beta-blockers as effective treatment options