Gestational diabetes maternal complications: Difference between revisions
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==Overview== | ==Overview== | ||
Maternal complications of GDM can be categorized | Maternal complications of GDM can be categorized into obstetric complications, and long term glycemic status-related complications. [[Pre-eclampsia]], [[polyhydramnios]], and difficult labor due to fetal macrosomia, are obstetric complications. The risk of developing prediabetes or even overt [[Diabetes mellitus|diabetes]] is increased in GDM patients. | ||
[[Pre-eclampsia]], [[polyhydramnios]] and difficult labor due to | |||
==Maternal complications== | ==Maternal complications== | ||
=== | ===Obstetric complications=== | ||
====Pre-eclampsia==== | ====Pre-eclampsia==== | ||
Women with GDM are at higher risk of developing [[pre-eclampsia]].<ref name="pmid15547538">{{cite journal |vauthors=Yogev Y, Xenakis EM, Langer O |title=The association between preeclampsia and the severity of gestational diabetes: the impact of glycemic control |journal=Am. J. Obstet. Gynecol. |volume=191 |issue=5 |pages=1655–60 |year=2004 |pmid=15547538 |doi=10.1016/j.ajog.2004.03.074 |url=}}</ref><ref name="pmid20207245">{{cite journal |vauthors=Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev |title=Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study: preeclampsia |journal=Am. J. Obstet. Gynecol. |volume=202 |issue=3 |pages=255.e1–7 |year=2010 |pmid=20207245 |pmc=2836485 |doi=10.1016/j.ajog.2010.01.024 |url=}}</ref> | Women with GDM are at a higher risk of developing [[pre-eclampsia]].<ref name="pmid15547538">{{cite journal |vauthors=Yogev Y, Xenakis EM, Langer O |title=The association between preeclampsia and the severity of gestational diabetes: the impact of glycemic control |journal=Am. J. Obstet. Gynecol. |volume=191 |issue=5 |pages=1655–60 |year=2004 |pmid=15547538 |doi=10.1016/j.ajog.2004.03.074 |url=}}</ref><ref name="pmid20207245">{{cite journal |vauthors=Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev |title=Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study: preeclampsia |journal=Am. J. Obstet. Gynecol. |volume=202 |issue=3 |pages=255.e1–7 |year=2010 |pmid=20207245 |pmc=2836485 |doi=10.1016/j.ajog.2010.01.024 |url=}}</ref> | ||
====Polyhydramnios==== | ====Polyhydramnios==== | ||
GDM is associated with increased risk of [[polyhydramnios]] probably because of fetal [[polyuria]].<ref name="pmid9397092">{{cite journal |vauthors=Casey BM, Lucas MJ, Mcintire DD, Leveno KJ |title=Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population |journal=Obstet Gynecol |volume=90 |issue=6 |pages=869–73 |year=1997 |pmid=9397092 |doi= |url=}}</ref> | GDM is associated with an increased risk of [[polyhydramnios]], probably because of fetal [[polyuria]].<ref name="pmid9397092">{{cite journal |vauthors=Casey BM, Lucas MJ, Mcintire DD, Leveno KJ |title=Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population |journal=Obstet Gynecol |volume=90 |issue=6 |pages=869–73 |year=1997 |pmid=9397092 |doi= |url=}}</ref> | ||
====Difficult labor==== | ====Difficult labor==== | ||
[[Macrosomia]] is a fetal complication of GDM that may result in difficult labor, [[shoulder dystocia]], [[brachial plexus injury]] and [[fractures]].<ref name="pmid7898833">{{cite journal |vauthors=Lipscomb KR, Gregory K, Shaw K |title=The outcome of macrosomic infants weighing at least 4500 grams: Los Angeles County + University of Southern California experience |journal=Obstet Gynecol |volume=85 |issue=4 |pages=558–64 |year=1995 |pmid=7898833 |doi=10.1016/0029-7844(95)00005-C |url=}}</ref><ref name="pmid9550201">{{cite journal |vauthors=Bérard J, Dufour P, Vinatier D, Subtil D, Vanderstichèle S, Monnier JC, Puech F |title=Fetal macrosomia: risk factors and outcome. A study of the outcome concerning 100 cases >4500 g |journal=Eur. J. Obstet. Gynecol. Reprod. Biol. |volume=77 |issue=1 |pages=51–9 |year=1998 |pmid=9550201 |doi= |url=}}</ref> | [[Macrosomia]] is a fetal complication of GDM that may result in difficult labor, [[shoulder dystocia]], [[brachial plexus injury]], and [[fractures]].<ref name="pmid7898833">{{cite journal |vauthors=Lipscomb KR, Gregory K, Shaw K |title=The outcome of macrosomic infants weighing at least 4500 grams: Los Angeles County + University of Southern California experience |journal=Obstet Gynecol |volume=85 |issue=4 |pages=558–64 |year=1995 |pmid=7898833 |doi=10.1016/0029-7844(95)00005-C |url=}}</ref><ref name="pmid9550201">{{cite journal |vauthors=Bérard J, Dufour P, Vinatier D, Subtil D, Vanderstichèle S, Monnier JC, Puech F |title=Fetal macrosomia: risk factors and outcome. A study of the outcome concerning 100 cases >4500 g |journal=Eur. J. Obstet. Gynecol. Reprod. Biol. |volume=77 |issue=1 |pages=51–9 |year=1998 |pmid=9550201 |doi= |url=}}</ref> | ||
===Long term complications=== | ===Long term complications=== | ||
*Most women with GDM return to | *Most women with GDM return to their normal glycemic status after delivery, however, there is a chance of developing [[impaired glucose tolerance]], impaired fasting glucose, and overt [[Diabetes mellitus|diabetes]] over the subsequent five years.<ref name="pmid10580075">{{cite journal |vauthors=Kjos SL, Buchanan TA |title=Gestational diabetes mellitus |journal=N. Engl. J. Med. |volume=341 |issue=23 |pages=1749–56 |year=1999 |pmid=10580075 |doi=10.1056/NEJM199912023412307 |url=}}</ref> | ||
*Chronic complications of diabetes should be considered. [[Diabetic nephropathy]], [[Retinopathy|diabetic retinopathy,]] cardiovascular complications and even [[DKA]] are | *Chronic complications of diabetes should be considered. [[Diabetic nephropathy]], [[Retinopathy|diabetic retinopathy,]] cardiovascular complications, and even [[DKA]], are severe complications, and they may develop during pregnancy.<ref name="pmid18392803">{{cite journal |vauthors=Arun CS, Taylor R |title=Influence of pregnancy on long-term progression of retinopathy in patients with type 1 diabetes |journal=Diabetologia |volume=51 |issue=6 |pages=1041–5 |year=2008 |pmid=18392803 |doi=10.1007/s00125-008-0994-z |url=}}</ref><ref name="pmid2331283">{{cite journal |vauthors=Reece EA, Winn HN, Hayslett JP, Coulehan J, Wan M, Hobbins JC |title=Does pregnancy alter the rate of progression of diabetic nephropathy? |journal=Am J Perinatol |volume=7 |issue=2 |pages=193–7 |year=1990 |pmid=2331283 |doi=10.1055/s-2007-999479 |url=}}</ref><ref name="pmid18487472">{{cite journal |vauthors=Shah BR, Retnakaran R, Booth GL |title=Increased risk of cardiovascular disease in young women following gestational diabetes mellitus |journal=Diabetes Care |volume=31 |issue=8 |pages=1668–9 |year=2008 |pmid=18487472 |pmc=2494649 |doi=10.2337/dc08-0706 |url=}}</ref><ref name="pmid23749791">{{cite journal |vauthors=Kessous R, Shoham-Vardi I, Pariente G, Sherf M, Sheiner E |title=An association between gestational diabetes mellitus and long-term maternal cardiovascular morbidity |journal=Heart |volume=99 |issue=15 |pages=1118–21 |year=2013 |pmid=23749791 |doi=10.1136/heartjnl-2013-303945 |url=}}</ref> | ||
==References== | ==References== | ||
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{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Obstetrics]] | [[Category:Obstetrics]] | ||
[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
Latest revision as of 21:51, 29 July 2020
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Gestational diabetes maternal complications On the Web |
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Risk calculators and risk factors for Gestational diabetes maternal complications |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Maternal complications of GDM can be categorized into obstetric complications, and long term glycemic status-related complications. Pre-eclampsia, polyhydramnios, and difficult labor due to fetal macrosomia, are obstetric complications. The risk of developing prediabetes or even overt diabetes is increased in GDM patients.
Maternal complications
Obstetric complications
Pre-eclampsia
Women with GDM are at a higher risk of developing pre-eclampsia.[1][2]
Polyhydramnios
GDM is associated with an increased risk of polyhydramnios, probably because of fetal polyuria.[3]
Difficult labor
Macrosomia is a fetal complication of GDM that may result in difficult labor, shoulder dystocia, brachial plexus injury, and fractures.[4][5]
Long term complications
- Most women with GDM return to their normal glycemic status after delivery, however, there is a chance of developing impaired glucose tolerance, impaired fasting glucose, and overt diabetes over the subsequent five years.[6]
- Chronic complications of diabetes should be considered. Diabetic nephropathy, diabetic retinopathy, cardiovascular complications, and even DKA, are severe complications, and they may develop during pregnancy.[7][8][9][10]
References
- ↑ Yogev Y, Xenakis EM, Langer O (2004). "The association between preeclampsia and the severity of gestational diabetes: the impact of glycemic control". Am. J. Obstet. Gynecol. 191 (5): 1655–60. doi:10.1016/j.ajog.2004.03.074. PMID 15547538.
- ↑ Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev, Yogev (2010). "Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study: preeclampsia". Am. J. Obstet. Gynecol. 202 (3): 255.e1–7. doi:10.1016/j.ajog.2010.01.024. PMC 2836485. PMID 20207245.
- ↑ Casey BM, Lucas MJ, Mcintire DD, Leveno KJ (1997). "Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population". Obstet Gynecol. 90 (6): 869–73. PMID 9397092.
- ↑ Lipscomb KR, Gregory K, Shaw K (1995). "The outcome of macrosomic infants weighing at least 4500 grams: Los Angeles County + University of Southern California experience". Obstet Gynecol. 85 (4): 558–64. doi:10.1016/0029-7844(95)00005-C. PMID 7898833.
- ↑ Bérard J, Dufour P, Vinatier D, Subtil D, Vanderstichèle S, Monnier JC, Puech F (1998). "Fetal macrosomia: risk factors and outcome. A study of the outcome concerning 100 cases >4500 g". Eur. J. Obstet. Gynecol. Reprod. Biol. 77 (1): 51–9. PMID 9550201.
- ↑ Kjos SL, Buchanan TA (1999). "Gestational diabetes mellitus". N. Engl. J. Med. 341 (23): 1749–56. doi:10.1056/NEJM199912023412307. PMID 10580075.
- ↑ Arun CS, Taylor R (2008). "Influence of pregnancy on long-term progression of retinopathy in patients with type 1 diabetes". Diabetologia. 51 (6): 1041–5. doi:10.1007/s00125-008-0994-z. PMID 18392803.
- ↑ Reece EA, Winn HN, Hayslett JP, Coulehan J, Wan M, Hobbins JC (1990). "Does pregnancy alter the rate of progression of diabetic nephropathy?". Am J Perinatol. 7 (2): 193–7. doi:10.1055/s-2007-999479. PMID 2331283.
- ↑ Shah BR, Retnakaran R, Booth GL (2008). "Increased risk of cardiovascular disease in young women following gestational diabetes mellitus". Diabetes Care. 31 (8): 1668–9. doi:10.2337/dc08-0706. PMC 2494649. PMID 18487472.
- ↑ Kessous R, Shoham-Vardi I, Pariente G, Sherf M, Sheiner E (2013). "An association between gestational diabetes mellitus and long-term maternal cardiovascular morbidity". Heart. 99 (15): 1118–21. doi:10.1136/heartjnl-2013-303945. PMID 23749791.