How Does Gestational Diabetes Impact Foetal Development?

How Does Gestational Diabetes Impact Foetal Development?

Gestational diabetes is a significant concern for expectant mothers, affecting about 15% of pregnancies worldwide. To put this into perspective, out of every 10 pregnant women, approximately 1 or 2 will develop this condition. Understanding its prevalence and implications of development of insulin resistance in pregnant women is crucial for ensuring the health as well as the well-being of both mother and baby. 

You may have lots of questions about the condition such as, what is gestational diabetes, and can someone get it even if they are not overweight or have never had blood sugar problems before pregnancy? You may also ask, how can I ensure that this condition is managed and the baby and the mother do not run into health problems in the future because of this diagnosis?

Gestational diabetes mellitus (GDM) is a diabetic condition that develops within the duration of a woman’s pregnancy. It affects how your body regulates blood sugar (glucose), a vital energy source for you and your growing baby. Usually women with gestational diabetes have healthy pregnancies, it’s important to understand how it can impact foetal development and take steps to manage it effectively. 

Blood Sugar and its Relation with Foetal Growth

During pregnancy, your placenta acts as a bridge between you and your baby, supplying oxygen and nutrients. Glucose from your bloodstream crosses the placenta, providing energy for the baby’s growth and development. Normally, your body produces insulin, a hormone that helps your cells take in the glucose from your bloodstream. However, with gestational diabetes, your body may not produce enough insulin, or your cells may become resistant to its effects, leading to high blood sugar levels.

This can lead to two major concerns for the baby:

Large Babies (Macrosomia): 

The excess glucose fuels rapid growth in your baby, potentially leading to macrosomia. This can complicate delivery, increasing the likelihood of needing a caesarean section (C-section). Additionally, it raises the risk of shoulder dystocia, where the baby’s shoulder gets stuck during delivery, and brachial plexus palsies, which are nerve injuries to the arm.

Hypoglycaemia: 

After birth, the baby no longer receives a constant supply of glucose from the mother. If the baby’s insulin levels are still high due to the prenatal environment, it can experience low blood sugar (hypoglycaemia) soon after birth. This can cause symptoms like jitteriness, sweating, and difficulty feeding.

Increased Risk of Birth Defects: 

While uncommon, uncontrolled gestational diabetes may slightly increase the risk of certain birth defects, especially heart defects, if blood sugar levels are not managed properly during the first trimester, a critical period for organ development.

Long-Term Health Risks: 

Babies of mothers with gestational diabetes have a higher likelihood to develop obesity and type 2 diabetes later in life.

Hyperbilirubinemia

Babies that are born to mothers with Gestational diabetes often have higher levels of bilirubin in their blood, leading to a condition called hyperbilirubinemia. This happens because these babies tend to have more red blood cells, which break down faster, releasing bilirubin. Since their kidneys are not fully developed, they cannot get rid of the excess bilirubin effectively, leading to other health issues such as jaundice (a yellowing of the skin and eyes).

This is relevant because it highlights a specific complication for babies born to mothers with gestational diabetes. Understanding this helps expectant mothers and healthcare providers such as your female obstetrician in Sydney to manage and monitor the baby’s health more closely after birth to address any issues promptly.

How to Address Potential Complications Due to Gestational Diabetes

Unfortunately, it is possible to develop gestational diabetes even if you are not overweight and have never had blood sugar problems before pregnancy. Gestational diabetes can affect any pregnant woman due to hormonal changes that interfere with the body’s ability to use insulin effectively. Here are a few important tips to do that.

Blood Sugar Stability for Both Mom and Baby:

  • Infant Needs: Due to unstable blood sugar after birth, your baby may need formula to maintain proper blood sugar levels. In some cases, this might require admission to the Neonatal Intensive Care Unit (NICU) for closer monitoring and management of hypoglycaemia (low blood sugar).
  • Maternal Hypoglycaemia: If medication like insulin is used to manage your blood sugar, there’s a risk of maternal hypoglycaemia. This can lead to unconsciousness and potentially be life-threatening.

Other Risks:

  • Preeclampsia: Gestational diabetes may increase the risk of preeclampsia, a serious pregnancy complication characterised by high blood pressure and other symptoms. This may sometimes require urgent  delivery of the baby.
  • Birth Defects: Uncontrolled gestational diabetes can slightly increase the risk of certain birth defects, particularly in the heart, brain, spine, kidneys, digestive system, and mouth.

Long-Term Implications:

  • Mothers: Women with gestational diabetes have a high probability, as high as 50% chance of developing type 2 diabetes before the 10th birthday of the baby.
  • Children: Children born to mothers with gestational diabetes are also at a higher risk of developing type 2 diabetes later in life.

Management Strategies for Gestational Diabetes

Fortunately, most cases of gestational diabetes can be effectively managed with a multi-pronged approach:

  • Diet and Exercise: Eating a healthy, balanced diet low in processed sugars and refined carbohydrates and incorporating regular exercise are key tools for controlling blood sugar levels. This may sometimes be harder to do during pregnancy. So, instead of buying packaged food from outside, have healthy food made at home which will have less sugar or refined carbohydrate content. 

Quench your cravings with healthy options without giving up on taste so you feel full. If you want to learn more about foods to ensure you get nutrients needed during pregnancy, you can read our blog “Top Foods to Combat Common Pregnancy Nutrient Deficiencies

  • Blood Sugar Monitoring: Regularly measuring your blood sugar levels with a finger prick test and a glucometer helps you and your doctor track your progress and adjust your management plan as needed. Keep in touch with a female obstetrician in Sydney, or wherever you live and ensure that your doctor has ample experience with handling patients with gestational diabetes.

  • Stress Reduction and Sleep: Maintain good sleep hygiene and manage stress levels so that it can contribute to better blood sugar control.
  • Take Medication if Necessary: If diet and exercise are not doing the job of keeping your blood sugar levels in control, your doctor may prescribe insulin or other medications. Follow the medication plan as directed.
  • Attend All Prenatal Appointments: Regular prenatal visits allow your obstetrician to monitor your health and the baby’s development closely. This can help to identify and address any potential issues early.
  • Postpartum Care: After delivery, continue monitoring your blood sugar levels and maintain a healthy lifestyle. Women who are diagnosed with gestational diabetes are at higher risk of developing or continuing to have type 2 diabetes later as well, so regular check-ups are important.

Additional Considerations:

  • Post-delivery Monitoring: After delivery, your baby’s blood sugar will be monitored closely to prevent complications like neurodevelopmental delays.
  • Weight Gain: Rapid weight gain during pregnancy may raise your likelihood of developing gestational diabetes
  • Future Testing: Women who had gestational diabetes are advised to undergo regular testing for type 2 diabetes, typically every three years.

Risk Factors of Gestational Diabetes 

Certain factors can make you more susceptible to gestational diabetes:

  • Ethnicity: Prevalence is higher in some ethnicities like Hispanic, African American, and Asian.
  • Overweight or Obesity: Being overweight or obese increases the risk.
  • Family History: A family history of type 2 diabetes raises your risk.
  • Previous Gestational Diabetes: Having gestational diabetes in a previous pregnancy increases the chance of recurrence.

Your journey through pregnancy can become stressful due to the diagnosis of conditions such as gestational pregnancy but it does not have to be.  Even though you can get diabetes during pregnancy without any history of blood sugar issues or obesity, it is possible to manage the negative outcomes of Gestational Diabetes by following a healthy lifestyle and monitoring your blood sugar levels.

Follow the advice of your doctor and be sure to go through all prenatal appointments for the well being of the mother and the baby. Get in touch with an obstetrician in your locality, and ensure she has experience dealing with other expectant mothers who have also gone through similar complications. If you are looking for a female obstetrician in Sydney, be sure to get in touch with Dr Kavita. She has hands down experience with prenatal and antenatal health and can guide you through any complications such as gestational diabetes, thyroid issues during pregnancy, etc.

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