Gestational diabetes effect on fetus
Introduction about Gestational diabetes effect on fetus
Gestational diabetes is a condition in which a pregnant mother has a high glucose level in the blood.
In most cases, this is physiological but in some others, it may cause complications either for the mother or her fetus, so we will describe the most common gestational diabetes complication on the mother and baby.
Immediate complications of gestational diabetes effect on fetus
- Due to the high level of blood glucose, early induction of labor may happen before week 37 of gestation.
- This early delivery can lead to more risks for the baby such as respiratory distress syndrome (RDS), jaundice, infection, difficulty in feeding, neonatal intensive care unit admission, and perinatal death.
Macrosomia (large birth weight)
- Macrosomia is the most serious gestational diabetes effect on the fetus, as it can cause shoulder dystocia that causes difficulty in labor and requirement of cesarean section.
Shoulder dystocia as Gestational diabetes effect on fetus
- One of the most serious complications of diabetes in pregnancy in which the baby’s shoulders can’t pass symphysis pubis that may cause:
- Birth trauma
- Head may be obstructed, blocking the infant’s respiration
- Erb’s palsy because there is a risk of brachial plexus injury with high birth weight child.
Neonatal hypoglycemia as Gestational diabetes effect on fetus
Hypoglycemia at birth is the commonest metabolic gestational diabetes complication on the fetus.
But You may wonder why hypoglycemia occurs in the baby?
Well, in response to maternal hyperglycemia, insulin release is enhanced in the fetus that causes hyperinsulinemia which in turn potentiates hypoglycemic effect on the fetus.
Complications of hypoglycemia
- Irritability and fatigue
- Central nervous system and cardiopulmonary disturbances
- If not treated, with time it can firstly cause mental retardation, recurrent seizures, delay in the development of the baby, and maybe personality disorders.
- Due to macrosomia, there is an increase in oxygen demand that leads to enhancement of erythropoiesis , and ultimately, polycythemia.
- Also, there is prematurity and impairment of hepatic conjugation of bilirubin.
- As a result, when RBCs break down, bilirubin (product of RBCs break down) increases leading to neonatal jaundice.
Gestational diabetes effect on fetus, Respiratory distress syndrome (RDS)
- It is considered to be the most dangerous gestational diabetes effect because it affects mother and baby health as well.
- As a result of high blood glucose level, there is a defect in surfactant (substance the decreases pulmonary surface tension) which cause difficulty in respiration and may be fatal.
Gestational diabetes effect on fetus, Congenital malformations
- The high blood sugar level in women with gestational DM can damage the developing organs of the fetus leading to congenital anomalies as:
- Spina bifida
- heart defect
- oral clefts
- gastrointestinal tract defect
- kidney defect
- limb deficiencies
how to prevent congenital malformations?
- In addition to taking care of blood glucose levels and a healthy balanced diet, you can take folic acid 5mg of folic acid per day in the first 12 weeks of pregnancy.
- Some babies may show hypocalcemia or hypomagnesemia
- This can cause seizures, may be a delay in the synthesis of parathyroid hormone.
- Later complications of gestational diabetes
- Childhood obesity and metabolic syndrome, because many studies suggest that childhood obesity may be the later diabetes effect on the fetus.
Gestational diabetes effect on fetus Conclusion
- Macrosomia and birth trauma are the most troublesome complication of diabetes in pregnancy because the damage occurs in both mother and her fetus.
- Administration of folic acid early in pregnancy can prevent congenital anomalies because its very important in neural tube development.
- Therefore Gestational diabetes effect can be avoided Keeping blood glucose level in the normal range through a healthy diet.