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Will gestational diabetes hurt my baby?
Most women who develop diabetes during pregnancy go on to have a healthy baby. Dietary changes and exercise may be enough to keep blood sugar (glucose) levels under control, though sometimes you may also need to take medication.
But untreated gestational diabetes can cause serious problems. If blood sugar levels remain elevated, too much glucose ends up in the baby's blood. When that happens, the baby's pancreas needs to produce more insulin to process the extra sugar.
Too much blood sugar and insulin can make a baby put on extra weight, which is stored as fat. This can make the baby grow very large (macrosomia).
Also, high blood sugar levels during pregnancy and labor increase the risk of a baby developing low blood sugar (hypoglycemia) after delivery. That's because the baby's body produces extra insulin in response to the mother's excess glucose. Insulin lowers the amount of sugar in the blood.
The signs and symptoms of hypoglycemia in an infant include:
- weak or high-pitched cry
- lethargy or sleepiness
- breathing problems
- skin that looks blue
- trouble feeding
- eye rolling
A baby may also be at higher risk for breathing problems at birth, especially if blood sugar levels aren't well controlled or the baby is delivered early. (If you have gestational diabetes, your baby's lungs tend to mature a bit later). The risk of newborn jaundice is higher too.
If your blood sugar control is especially poor, the baby's heart function could be affected as well, which can contribute to breathing problems. Gestational diabetes sometimes thickens a baby's heart muscle (hypertrophic cardiomyopathy), causing the baby to breathe rapidly and not be able to get enough oxygen from her blood.
It's understandable to feel anxious about how gestational diabetes might affect your baby's health. The good news is that if your blood sugar is well managed, either through diet or medication (or both), your baby is much less likely to have any problems.
What's wrong with having a big baby?
Having a big baby may make labor and birth more difficult. There's also a higher risk of a big baby getting stuck in the birth canal during delivery (shoulder dystocia). This can result in injury to nerves in the neck and shoulders (brachial plexus injury) or even a broken collarbone.
These injuries almost always heal without causing any permanent problems, but in rare cases shoulder dystocia results in a baby not getting enough oxygen during birth.
Your healthcare provider will do regular ultrasound exams throughout your pregnancy, and you may have a scan in your third trimester to check how large your baby's growing. Your healthcare provider may recommend a planned c-section if your baby seems especially big.
There are also long-term risks associated with having a big baby. Large babies are more likely to become overweight or obese during childhood. They also have a higher risk of developing type 2 diabetes when they're older.
Will my baby need special care after birth?
Probably. Because there's a risk of low blood sugar from gestational diabetes when a baby is born, many get blood glucose testing shortly after delivery. If these tests are out of a healthy range, your provider will monitor your baby closely.
Feeding your baby as soon as possible after birth, preferably by breastfeeding, can prevent or correct hypoglycemia. In severe cases of hypoglycemia, a baby will be given an IV glucose solution.
It's possible that your baby will need to spend some time in the neonatal intensive care unit (NICU) after birth. It depends on how the birth went and your baby's condition.
Special care may be more likely if your baby:
- is born early (premature)
- needs help breathing
- has another medical condition, such as jaundice
- has hypoglycemia
Even if your baby is doing well, regular blood tests are necessary for a day or two to make sure blood sugar levels are returning to normal.
Visit the Society for Maternal-Fetal Medicine's website for more information and to find an MFM specialist near you.