CONSEQUENCES OF GDM

GDM (Gestational Diabetes Mellitus) is a worry in itself for a pregnant woman due to health issues, along with that the psychological pressure it creates make pregnancy period difficult. But the sad truth is that, this difficulties are just the beginning, the complications associated with GDM to both mother and the new born are much worse as the time passes.

Consequences to mother:

• Infection:  Gestational diabetes augments group B streptococcus infection by disrupting maternal immunity and thereby causes disturbances in vaginal flora and vaginal infection. 

• Pre- Eclampsia and Eclampsia: The increased blood pressure during pregnancy called an eclampsia, is dangerous as it makes more complications such as breathing difficulties, blood clots, stroke, coma, heart failure and so on and eclampsia can extend up to six weeks after delivery.

• Hemorrhage : It  has been reported that GDM females have 3-5 times higher risk of hemorrhage than normal glucose tolerance females, as GDM possesses the potential for hypocoagulability ,  which may contribute to the occurrence of hemorrhage.

• Post-partum depression: There is a reciprocal relationship between GDM and postpartum depression, meaning that depression can also increase the risk of GDM and vice-versa.

• Caesarean delivery:  Increased weight of the child, which is nearly 4 kg, makes it difficult for the occurrence of a normal delivery.

Consequences to new born

• Macrosomia: Children of a GDM mother can have weight even more than 4kg, as the excess glucose crosses the placenta to the fetus, causing the baby’s pancreas to produce more insulin, leading to increased fetal growth.

• Neonatal Hypoglycemia: Immediately after delivery, the baby starts to produce more insulin, the way the baby used to produce it when it was in the womb. After delivery, even though there is no excess glucose in its body, as there is no glucose supply from the mother’s body, the baby’s body still produces more insulin without understanding its environmental change. And this increased insulin reduces the glucose level in the baby’s body causing Hypoglycemia. If proper medical support is not given, it can even lead to the death of the new born.

• Respiratory Distress syndrome: GDM increases the breathing difficulties of new borns, due to insufficient surfactant production in the lungs as GDM adversely affects fetal lung development.

• Shoulder Dystocia: It occurs when one or both of the baby’s shoulders gets stuck inside your pelvis during childbirth due to macrosomic babies.

• Congenital Malformations: GDM can mainly affect the central nervous system and cardiovascular system of new borns. Spina bifida( incomplete growth of the spinal cord), limb defects, Microcephaly etc  are all some of the malformations associated with GDM.

• Still birth and pre-term birth are the most severe effects of GDM among new born.

Though there are many complications associated with GDM for mothers and new borns, its not the time to fear and sit back, but to take proactive steps to improve your health by improving your dietary preferences and health choices.