I Have Gestational Diabetes: What are the Risks to me?

The risk factors for Gestational Diabetes Mellitus (GDM) occurs when the body does not produce enough insulin and blood sugar levels get too high during pregnancy.  It most commonly occurs in the second and third trimester. Prevalence varies around the world, but with obesity considered a major risk factor, and the number of obese females increasing, GDM is becoming a significant health issue of the 21st Century.

Having GDM does increase the risk of complications for both mother and baby. However, the risks from GDM can be reduced if it is detected early and managed well. This article looks at what impact GDM has on the mother’s health; to see the risks to her offspring click here.

Pregnancy complications

Women who are diagnosed with GDM are at increased risk of pregnancy complications including polyhydramnios, which occurs when there is an excess of amniotic fluid. They are also at increased risk of developing hypertension (high blood pressure) and preeclampsia. Preeclampsia is a life-threatening condition that requires close medical monitoring. In severe cases it can lead to maternal seizures and will often result in premature delivery.

Delivery

In terms of delivery, women with GDM are more likely to experience premature labour. In some cases this is spontaneous, but, in many cases, rapid growth of the baby in utero necessitates medical intervention. Babies born to mothers with GDM are frequently above the 90th percentile and if allowed to go to full term can weigh more than 4.5 KG at birth. Delivering such a large baby puts the mother at increased risk of complications and, therefore, induced delivery and planned C-sections are common following a GDM diagnosis. The mother also has an increased risk of postpartum haemorrhage, which can be very dangerous if not attended to rapidly.

Long-term health impact

GDM can also have longer-term effects on the mother’s health. Women who are diagnosed with GDM are over 7 times more likely to develop type 2 diabetes; most often in the first 5 years post-childbirth. Some women actually find that the GDM that is diagnosed during pregnancy persists after delivery and is reclassified as type 2 diabetes. The risk of a woman developing GDM during a subsequent pregnancy is approximately 48%, but can be significantly higher if she falls into a high risk group.

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Sources:

• Bellamy, L, et al. “Type 2 Diabetes Mellitus after Gestational Diabetes: a Systematic Review and Meta-Analysis.” The Lancet, vol. 373, no. 9677, 23 May 2009, pp. 1773–1779., doi:10.1016/S0140-6736(09)60731-5.
• Bener, A, et al. “Prevalence of Gestational Diabetes and Associated Maternal and Neonatal Complications in a Fast-Developing Community: Global Comparisons.” International Journal of Women’s Health, vol. 3, 2011, pp. 367–373., doi:10.2147/IJWH.S26094.
• “Gestational Diabetes (Overview).” NHS, www.nhs.uk/conditions/gestational-diabetes/.
• Groof, Z, et al. “Prevalence, Risk Factors, and Fetomaternal Outcomes of Gestational Diabetes Mellitus in Kuwait: A Cross-Sectional Study.” Journal of Diabetes Research, vol. 2019, no. 9136250, 3 Mar. 2019, doi:10.1155/2019/9136250.
• Schwartz, N, et al. “The Prevalence of Gestational Diabetes Mellitus Recurrence–Effect of Ethnicity and Parity: a Metaanalysis.” American Journal of Obstetrics and Gynecology, vol. 213, no. 3, Sept. 2015, pp. 310–317., doi:10.1016/j.ajog.2015.03.011.