Gestational diabetes fetal 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
Fetal complications
- Poor glycemic control during pregnancy may lead to some fetal disturbances. Congenital malformations are the most common complications seen in GDM compared to healthy mothers.[1]
- Maternal hyperglycemia will lead to hyperinsulinemia which secondarily will result in fetal macrosomia.
- Fetal macrosomia results in increased metabolic demands that finally will cause increased mortality, metabolic acidosis, alterations in fetal iron distribution, increased erythropoiesis and resulting polycythemia.[2][3]
- Stillbirth is another complication of GDM which is because of increased catecholamine release, hypertension and increased cardiac workload.[4] Hypertrophic cardiomyopathy due to increased oxidative stress is another cause of stillbirth in hyperglycemic mothers.[5]
Neonatal complications
Insulin resistance, hyperinsulinemia and increased metabolic demands may result in neonatal co-morbidities including,
| Neonatal complications | Frequncy♦ | |
|---|---|---|
| GDM |
|
|
♦ Based on a survey on GDM mothers[6]
† Birth weight greater than the 90th percentile
‡ 14% with gestational age <34 weeks and 22% with GA between 34 and 37 weeks
References
- ↑ Mitanchez D, Burguet A, Simeoni U (2014). "Infants born to mothers with gestational diabetes mellitus: mild neonatal effects, a long-term threat to global health". J. Pediatr. 164 (3): 445–50. doi:10.1016/j.jpeds.2013.10.076. PMID 24331686.
- ↑ Nold JL, Georgieff MK (2004). "Infants of diabetic mothers". Pediatr. Clin. North Am. 51 (3): 619–37, viii. doi:10.1016/j.pcl.2004.01.003. PMID 15157588.
- ↑ Widness JA, Teramo KA, Clemons GK, Voutilainen P, Stenman UH, McKinlay SM, Schwartz R (1990). "Direct relationship of antepartum glucose control and fetal erythropoietin in human type 1 (insulin-dependent) diabetic pregnancy". Diabetologia. 33 (6): 378–83. PMID 2199280.
- ↑ Kitzmiller JL (1993). "Sweet success with diabetes. The development of insulin therapy and glycemic control for pregnancy". Diabetes Care. 16 Suppl 3: 107–21. PMID 8299468.
- ↑ Topcuoglu S, Karatekin G, Yavuz T, Arman D, Kaya A, Gursoy T, Ovalı F (2015). "The relationship between the oxidative stress and the cardiac hypertrophy in infants of diabetic mothers". Diabetes Res. Clin. Pract. 109 (1): 104–9. doi:10.1016/j.diabres.2015.04.022. PMID 25934526.
- ↑ Cordero L, Treuer SH, Landon MB, Gabbe SG (1998). "Management of infants of diabetic mothers". Arch Pediatr Adolesc Med. 152 (3): 249–54. PMID 9529462.