Gestational diabetes maternal complications
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Maternal complications of GDM can be categorized into obstetric complications, and long term glycemic status-related complications. Pre-eclampsia, polyhydramnios, and difficult labor due to fetal macrosomia, are obstetric complications. The risk of developing prediabetes or even overt diabetes is increased in GDM patients.
Maternal complications
Obstetric complications
Pre-eclampsia
Women with GDM are at a higher risk of developing pre-eclampsia.[1][2]
Polyhydramnios
GDM is associated with an increased risk of polyhydramnios, probably because of fetal polyuria.[3]
Difficult labor
Macrosomia is a fetal complication of GDM that may result in difficult labor, shoulder dystocia, brachial plexus injury, and fractures.[4][5]
Long term complications
- Most women with GDM return to their normal glycemic status after delivery, however, there is a chance of developing impaired glucose tolerance, impaired fasting glucose, and overt diabetes over the subsequent five years.[6]
- Chronic complications of diabetes should be considered. Diabetic nephropathy, diabetic retinopathy, cardiovascular complications, and even DKA, are severe complications, and they may develop during pregnancy.[7][8][9][10]
References
- ↑ Yogev Y, Xenakis EM, Langer O (2004). "The association between preeclampsia and the severity of gestational diabetes: the impact of glycemic control". Am. J. Obstet. Gynecol. 191 (5): 1655–60. doi:10.1016/j.ajog.2004.03.074. PMID 15547538.
- ↑ Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev (2010). "Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study: preeclampsia". Am. J. Obstet. Gynecol. 202 (3): 255.e1–7. doi:10.1016/j.ajog.2010.01.024. PMC 2836485. PMID 20207245.
- ↑ Casey BM, Lucas MJ, Mcintire DD, Leveno KJ (1997). "Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population". Obstet Gynecol. 90 (6): 869–73. PMID 9397092.
- ↑ Lipscomb KR, Gregory K, Shaw K (1995). "The outcome of macrosomic infants weighing at least 4500 grams: Los Angeles County + University of Southern California experience". Obstet Gynecol. 85 (4): 558–64. doi:10.1016/0029-7844(95)00005-C. PMID 7898833.
- ↑ Bérard J, Dufour P, Vinatier D, Subtil D, Vanderstichèle S, Monnier JC, Puech F (1998). "Fetal macrosomia: risk factors and outcome. A study of the outcome concerning 100 cases >4500 g". Eur. J. Obstet. Gynecol. Reprod. Biol. 77 (1): 51–9. PMID 9550201.
- ↑ Kjos SL, Buchanan TA (1999). "Gestational diabetes mellitus". N. Engl. J. Med. 341 (23): 1749–56. doi:10.1056/NEJM199912023412307. PMID 10580075.
- ↑ Arun CS, Taylor R (2008). "Influence of pregnancy on long-term progression of retinopathy in patients with type 1 diabetes". Diabetologia. 51 (6): 1041–5. doi:10.1007/s00125-008-0994-z. PMID 18392803.
- ↑ Reece EA, Winn HN, Hayslett JP, Coulehan J, Wan M, Hobbins JC (1990). "Does pregnancy alter the rate of progression of diabetic nephropathy?". Am J Perinatol. 7 (2): 193–7. doi:10.1055/s-2007-999479. PMID 2331283.
- ↑ Shah BR, Retnakaran R, Booth GL (2008). "Increased risk of cardiovascular disease in young women following gestational diabetes mellitus". Diabetes Care. 31 (8): 1668–9. doi:10.2337/dc08-0706. PMC 2494649. PMID 18487472.
- ↑ Kessous R, Shoham-Vardi I, Pariente G, Sherf M, Sheiner E (2013). "An association between gestational diabetes mellitus and long-term maternal cardiovascular morbidity". Heart. 99 (15): 1118–21. doi:10.1136/heartjnl-2013-303945. PMID 23749791.