Birth defects due to gestational diabetes in Mother

 Birth defects due to gestational diabetes in Mother 

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Birth defects due to gestational diabetes in Mother
Posted in 2015

Diabetics and women who get gestational diabetes (diabetes that occurs during pregnancy) are advised to maintain strict control over the condition during their pregnancy. Raised blood sugar, especially during the first trimester, can cause birth defects and miscarriage. Gestational diabetes tends to have an onset towards the end of pregnancy and is typically less dangerous than traditional diabetes, but can lead to macrosomia, or a “fat” baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby’s pancreas, these newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes” (from the ADA).

Diabetes and Birth Defects

Correa and his colleagues evaluated mothers of more than 13,000 infants with birth defects and nearly 5,000 infants without birth defects. The children were born between 1997 and 2003 and were participants in the National Birth Defects Prevention Study, which drew data from 10 birth-defect surveillance systems in 10 states.
They looked at whether a mother had diabetes, either type 1 or type 2, before becoming pregnant or whether she developed it during pregnancy. Women also reported other information, including height and weight, so their BMI could be calculated. Twenty-four mothers of the nearly 5,000 infants without birth defects had diabetes before pregnancy,  283 moms of the babies with birth defects had diabetes before pregnancy.

My advise
1..  The couple should control diabetes if any before conceive
2..  Infants of mothers with diabetes are at greater risk for several problems, especially if blood glucose levels are not carefully controlled, including the following:
  • Birth defects. Birth defects are more likely in infants of diabetic mothers, especially insulin-dependent women who may have two to six times greater the risk of major birth defects. Some birth defects are serious enough to cause fetal death. Birth defects usually originate sometime during the first trimester of pregnancy. They are more likely in women with pre-gestational diabetes, who may have changes in blood glucose during that time. Overall, major birth defects may occur in about 5 to 10 percent of infants born to insulin-dependent women. Major birth defects that may occur in infants of diabetic mothers include the following:
    • Heart and connecting blood vessels
    • Brain and spine abnormalities
    • Urinary and kidney
    • Digestive tract
  • 3... Stillbirth (fetal death). Stillbirth is more likely in pregnant women with diabetes. The fetus may grow slowly in the uterus due to poor circulation or other conditions, such as high blood pressure or microvascular disease, which can complicate diabetic pregnancy. The exact reason stillbirths occur with diabetes is unknown. The risk of stillbirth increases in women with poor blood glucose control and with blood vessel changes.
  • 4... Macrosomia. Macrosomia refers to a baby that is considerably larger than normal. All of the nutrients the fetus receives come directly from the mother's blood. If the maternal blood has too much glucose, the pancreas of the fetus senses the high glucose levels and produces more insulin in an attempt to use this glucose. The fetus converts the extra glucose to fat. Even when the mother has gestational diabetes, the fetus is able to produce all the insulin it needs. The combination of high blood glucose levels from the mother and high insulin levels in the fetus results in large deposits of fat that causes the fetus to grow excessively large
  • 5... Birth injury. Birth injury may occur due to the baby's large size and difficulty being born.
  • 6..  Hypoglycemia. Hypoglycemia is low levels of blood glucose in the baby immediately after delivery. This problem occurs if the mother's blood glucose levels have been consistently high causing the fetus to have a high level of insulin in its circulation. After delivery, the baby continues to have a high insulin level, but no longer has the high level of glucose from the mother, resulting in the newborn's blood glucose level becoming very low. The baby's blood glucose level is checked after birth, and if the level is too low, it may be necessary to give the baby glucose intravenously.
  • 7... Respiratory distress (difficulty breathing). Too much insulin or too much glucose in a baby's system may delay lung maturation and cause respiratory difficulties in babies. This is more likely in babies born before 37 weeks of pregnancy.
  • 8... Your food can control gestational diabetes during pregnancy.   Eat healthy food to protect your health and your child's health

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