Gestational diabetes is a condition that affects some women during their pregnancy. It occurs when a woman who has never had diabetes develops high levels of blood sugar. According to the American Diabetes Association, about four percent of all pregnant women develop gestational diabetes. This can affect the developing baby and lead to low blood sugar in the newborn.
Causes of Gestational Diabetes
Although the exact cause of gestational diabetes is not known, it is thought that the placenta, the organ that attaches the developing fetus to the uterus, interferes with the body's ability to utilize insulin, the hormone in charge of controlling blood sugar levels. This causes a condition called insulin resistance. Insulin works by helping the body change glucose into energy. Without insulin, glucose levels in the blood build up to high levels, causing hyperglycemia. High glucose levels can have serious health effects in the newborn baby, including low blood sugar.
Symptoms of Gestational Diabetes in the Newborn
The high glucose levels can cause the baby to grow large, with extra fat. According to the National Diabetes Education Program, this can result in a difficult delivery, putting the baby at risk for birth trauma. According to the Merck Manual, hypoglycemia, or low blood sugar, can also occur in the newborn. This occurs when the baby, who produces large amounts of insulin to deal with the oversupply of glucose, is separated from the placenta. The high levels of insulin continue to utilize glucose, leading to low sugar levels and hypoglycemia. Symptoms of hypoglycemia in a newborn include jitteriness, listlessness, difficulty feeding and lethargy.
Complications
Other complications of gestational diabetes in a newborn include delay in the development of the lungs, leading to respiratory difficulty; excess production of red blood cells, giving the newborn a flushed appearance and predisposing the infant to the development of jaundice; and birth injuries, including fractures of the collarbone and damage to the shoulder nerves. Because of the baby's size, mothers with gestational diabetes often undergo cesarean section for the delivery.
Treatment
The treatment of the low blood sugar in infants of diabetic mothers includes intravenous infusions of glucose and frequent feedings, either by mouth or via a feeding tube that goes directly into the stomach. Frequent monitoring of blood sugar levels is important to avoid complications like seizures. Infants with respiratory distress may need oxygen or even a breathing tube to maintain appropriate oxygen levels.
Risk Factors
Risk factors for developing gestational diabetes include age older that 25, family history of diabetes and being overweight. Medline Plus also mentions high blood pressure, history of previous unexplained stillbirth, and previous babies weighing more than 9 lb. To prevent complications, all pregnant women receive a glucose tolerance test between the 24th and 28th week of pregnancy. This test screens for gestational diabetes by assessing a pregnant woman's response to ingesting a liquid containing a large amount of glucose. An abnormal test, with greater than normal blood glucose levels after ingesting the liquid, indicates a higher risk for gestational diabetes and warrants close monitoring of blood glucose levels.
