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Complications
By Mayo Clinic staffMost women who have gestational diabetes deliver healthy babies. However, gestational diabetes that's not carefully managed can lead to uncontrolled blood sugar levels and cause problems for you and your baby.
Complications that may affect your baby
If you have gestational diabetes, your baby may be at increased risk of:
- Excess growth. Extra glucose will cross the placenta, which triggers your baby's pancreas to make extra insulin. This can cause your baby to grow too large (macrosomia). Very large babies are more likely to become wedged in the birth canal, sustain birth injuries or require a C-section birth.
- Low blood sugar (hypoglycemia). Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth because their own insulin production is high. Severe episodes of this problem may provoke seizures in the baby. Prompt feedings and sometimes an intravenous glucose solution can return the baby's blood sugar level to normal.
- Respiratory distress syndrome. If your baby is delivered early, respiratory distress syndrome — a condition that makes breathing difficult — is possible. Babies born to women with gestational diabetes have more breathing problems than do those born to women without the problem, even at the same gestational age. Babies who have respiratory distress syndrome might need help breathing until their lungs become stronger.
- Jaundice. This yellowish discoloration of the skin and the whites of the eyes may occur if a baby's liver isn't mature enough to break down a substance called bilirubin, which normally forms when the body recycles old or damaged red blood cells. Although jaundice usually isn't a cause for concern, careful monitoring is important.
- Type 2 diabetes later in life. Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
- Developmental problems. If you have gestational diabetes, your child may have an increased risk of problems with motor skill development, such as walking, jumping, or other activities that require balance and coordination. An increased risk of attention problems or hyperactivity disorders also is a concern.
Rarely, untreated gestational diabetes results in a baby's death either before or shortly after birth.
Complications that may affect you
Gestational diabetes may also increase your personal risk of:
- Preeclampsia. Gestational diabetes increases the risk of preeclampsia, a condition characterized by high blood pressure and excess protein in the urine after the 20th week of pregnancy. Left untreated, preeclampsia can lead to serious or even life-threatening complications for both mother and baby.
- Urinary tract infections. Women with gestational diabetes experience twice the number of urinary tract infections during pregnancy than other pregnant women experience. This is likely due to excess glucose in the urine.
- Future diabetes. If you have gestational diabetes, you're more likely to have it again with a future pregnancy. You're also more likely to develop diabetes — typically type 2 diabetes — as you get older. However, making healthy lifestyle choices such as eating healthy foods and exercising can help reduce the risk of future type 2 diabetes. Of those women with a history of gestational diabetes who reach their ideal body weight after delivery, fewer than 25 percent develop type 2 diabetes.
References
- Strehlow SL, et al. Diabetes mellitus & pregnancy. In: DeCherney AH, et al. Current Diagnosis & Treatment: Obstetrics & Gynecology. 10th ed. New York, N.Y.: McGraw-Hill; 2007. http://www.accessmedicine.com/content.aspx?aID=2385290. Accessed Jan. 9, 2009.
- Jovanovic L. Screening and diagnosis of gestational diabetes mellitus. http://www.uptodate.com/home/index.html. Accessed Jan. 5, 2009.
- Jovanovic L. Treatment and course of gestational diabetes mellitus. http://www.uptodate.com/home/index.html. Accessed Jan. 9, 2009.
- Diabetes. In: Cunningham FG, et al. Williams Obstetrics. 22nd ed. New York, N.Y.: McGraw-Hill; 2005:1172.
- Cheng YV, et al. Gestational weight gain and gestational diabetes mellitus. Obstetrics & Gynecology. 2008;112:1015.
- Gestational diabetes. American Diabetes Association. http://www.diabetes.org/gestational-diabetes.jsp. Accessed Jan. 6, 2009.
- Gilmartin AH, et al. Gestational diabetes mellitus. Reviews in Obstetrics & Gynecology. 2008;1:129. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=19015764. Accessed Jan. 3, 2009.
