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Diabetes In Pregnancy

How Does Diabetes Affect Pregnancy?

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Contributing Author: Guy Slowik FRCS

In women with gestational diabetes and type 2 diabetes, the sugar (glucose) in your blood directly affects the size of your baby. If your blood sugar level is high, the baby gets too much nourishment and overgrows. This can lead to a condition called macrosomia or "fat" baby. Macrosomia causes problems for both you and your baby.

What Are The Risks To The Baby?

Babies who get too much sugar (glucose) from their mother's blood accumulate fat around the shoulders and trunk. That can make them too difficult to delivery vaginally. Your doctor may recommend delivering the baby early.

Other risks associated with gestational diabetes and type 2 diabetes include:

  • Damage to the baby's shoulders during delivery
  • Low blood sugar in the baby at birth
  • Higher risk for obesity and type 2 diabetes later in life for the baby
  • Jaundice (a yellowish discoloration of the skin) two to three days after birth

Risks associated with type 1 diabetes include:

  • Low blood sugar at birth
  • Breathing problems at birth
  • Jaundice two to three days after birth
  • Increased chance of major birth defects

What Are The Risks To The Mother?

Risks associated with gestational and type 2 diabetes include:

  • Possible need for cesarean delivery
  • Pregnancy-related high blood pressure and swelling of the hands and feet
  • Urinary tract infections
  • An increased chance of developing diabetes later in life or in a subsequent pregnancy

Risks associated with type 1 diabetes include:

  • Premature labor and delivery
  • Possible need for cesarean delivery
  • Pregnancy-related high blood pressure and swelling of the hands and feet
  • Urinary tract infections
  • Buildup of ketones (harmful acids) in the blood
  • Possible worsening of eye disease
  • Possible (reversible) progression of kidney disease

How Can I Avoid Complications?

Problems associated with diabetes in pregnancy are manageable and preventable. The key to prevention is careful control of your blood sugar as soon as gestational diabetes is diagnosed.

  • Women with pre-existing diabetes should get their blood sugar under control three to six months before conception, to lessen the risk of birth defects.
  • Gestational diabetes, which starts later in pregnancy, does not cause birth defects.

Will My Baby Be Healthy?

During pregnancy, several tests will be done to make sure your baby is developing properly and to help predict the time of delivery.

  • Ultrasound - This test involves passing a special wand over the skin of the abdomen. Sound waves are transmitted into the body and bounce back, creating an image that shows the growth and development of the baby.
  • Alpha-fetoprotein test - This is a blood test that detects a particular protein produced by the baby's liver. Abnormal levels of alpha-fetoprotein (AFP) indicate a high risk for certain types of birth defects.
  • Amniocentesis - In this test, a long thin needle is inserted into the abdomen and a sample of amniotic fluid (the fluid that surrounds the baby within the uterus) is taken. Cells in the fluid help doctors determine if the baby's lungs are mature enough to withstand early delivery.
  • Non-stress test - A fetal monitor, strapped to the mother's abdomen, records the baby's heart rate for a short period of time. This reading helps doctors assess the health of the baby in the last weeks of pregnancy.
  • Fetal monitoring - During labor and delivery, a fetal monitor keeps constant track of the baby's heart rate in order to detect the first indications of distress.




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From Andrew Maynard - Chair of the University of Michigan Department of Environmental Health Sciences, with help from David Faulkner - 2013 Master of Public Health graduate.