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==Overview==
==Overview==
==Natural History and Prognosis==
Most women with GDM will return to their pre-pregnancy glycemic status after delivery, but there is an increased chance of developing overt diabetes or prediabetes during the next 5 years. Recurrent GDM is another subject that physicians should be aware of.
==Complications==
Poorly controlled gestational diabetes can lead to the growth of a [[macrosomic]] or large baby. This in turn increases the risk of instrumental deliveries (eg [[forceps]], [[vacuum]] and [[caesarean section]]). Babies born to mothers with diabetes are also more likely to have [[hypoglycemia]] and other chemical imbalances which need to be monitored and possibly corrected after birth.  These babies may need specialized care in the [[postpartum]] period.  Additionally, poor control of diabetes can lead to a variety of birth defects involving the heart, kidneys, eyes, and central nervous system, as well as increased risk of [[miscarriage]].  However birth defects are more common in babies whose mother had diabetes in the first trimester, in which case the mother likely had undiagnosed Type 1 or Type 2 diabetes, rather than gestational diabetes. Gestational diabetes typically does not occur until after the period of [[organogenesis]], thus birth defects are unlikely.  


In the future the mother is at increased risk of developing type 2 diabetes.
==Natural History==
*If GDM is left untreated, serious fetal complications can develop during pregnancy, and progression to overt diabetes  can also occur in the long term.
==Prognosis==
*Most of women with GDM return to their pre pregnancy glycemic status after delivery.
*Women diagnosed with gestational diabetes have an increased risk of developing overt [[diabetes mellitus]] in the future. Women requiring insulin to manage gestational diabetes have a 50% risk of developing diabetes within the next five years.<ref name=AMN>{{cite web | Carla Janzen, MD, Jeffrey S. Greenspoon, MD | title =Gestational Diabetes | publisher=Armenian Medical Network | work =Diabetes Mellitus & Pregnancy - Gestational Diabetes | url=http://www.health.am/pregnancymore/diabetes-intrapartum-postpartum-management/ | year = 2006 | accessdate=2007-02-28}}</ref>
*One-third to two-thirds of women will re-experience GDM in subsequent pregnancies.<ref name="pmid20630491">{{cite journal |vauthors=Getahun D, Fassett MJ, Jacobsen SJ |title=Gestational diabetes: risk of recurrence in subsequent pregnancies |journal=Am. J. Obstet. Gynecol. |volume=203 |issue=5 |pages=467.e1–6 |year=2010 |pmid=20630491 |doi=10.1016/j.ajog.2010.05.032 |url=}}</ref><ref name="pmid11315827">{{cite journal |vauthors=MacNeill S, Dodds L, Hamilton DC, Armson BA, VandenHof M |title=Rates and risk factors for recurrence of gestational diabetes |journal=Diabetes Care |volume=24 |issue=4 |pages=659–62 |year=2001 |pmid=11315827 |doi= |url=}}</ref>
*Risk factors for the recurrence of GDM include older age, multiparity, higher maternal weight in the index pregnancy, and weight gain between pregnancies.<ref name="pmid8941462">{{cite journal |vauthors=Moses RG |title=The recurrence rate of gestational diabetes in subsequent pregnancies |journal=Diabetes Care |volume=19 |issue=12 |pages=1348–50 |year=1996 |pmid=8941462 |doi= |url=}}</ref><ref name="pmid11315827">{{cite journal |vauthors=MacNeill S, Dodds L, Hamilton DC, Armson BA, VandenHof M |title=Rates and risk factors for recurrence of gestational diabetes |journal=Diabetes Care |volume=24 |issue=4 |pages=659–62 |year=2001 |pmid=11315827 |doi= |url=}}</ref>


==Complications==
==References==
Unlike pre-gestational diabetes, gestational diabetes generally does not cause birth defects. Birth defects usually originate sometime during the first trimester (before the 13th week) of pregnancy.
 
Infants of mothers with gestational diabetes are vulnerable to several chemical imbalances, such as low serum calcium and low serum magnesium levels, but in general, there are two major problems of gestational diabetes: macrosomia and hypoglycemia.<ref name=UMM>{{cite web | Content was last reviewed by a University of Maryland Medicine expert  | title =Gestational Diabetes | publisher=University of Maryland Medicine | work =An overview of gestational diabetes, including risk factors and treatment | url=http://www.umm.edu/diabetes-info/gesta.htm | year = 2003 | month= May 14 | accessdate=2006-11-29}}</ref>
 
'''For Mother'''
* [[Hypertension]]
* [[Preeclampsia]]
* Increased risk for developing type 2 diabetes


'''For Baby'''
{{Reflist|2}}
* [[Macrosomia]] (macrosomia can also increase the likelihood of a caesarean-section delivery)
* [[Hypoglycemia]]
* [[Jaundice]]
* Low [[calcium]] and [[magnesium]]
* [[Respiratory distress syndrome]] (RDS)
* Increased risk for childhood and adult obesity
* Increased risk of type 2 diabetes later in life


==References==
{{reflist|2}}
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[[Category:Disease]]
 
[[Category:Obstetrics]]
[[Category:Obstetrics]]
[[Category:Endocrinology]]
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[[Category:Needs content]]
[[Category:Emergency medicine]]

Latest revision as of 21:51, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]


Overview

Most women with GDM will return to their pre-pregnancy glycemic status after delivery, but there is an increased chance of developing overt diabetes or prediabetes during the next 5 years. Recurrent GDM is another subject that physicians should be aware of.

Natural History

  • If GDM is left untreated, serious fetal complications can develop during pregnancy, and progression to overt diabetes can also occur in the long term.

Prognosis

  • Most of women with GDM return to their pre pregnancy glycemic status after delivery.
  • Women diagnosed with gestational diabetes have an increased risk of developing overt diabetes mellitus in the future. Women requiring insulin to manage gestational diabetes have a 50% risk of developing diabetes within the next five years.[1]
  • One-third to two-thirds of women will re-experience GDM in subsequent pregnancies.[2][3]
  • Risk factors for the recurrence of GDM include older age, multiparity, higher maternal weight in the index pregnancy, and weight gain between pregnancies.[4][3]

References

  1. "Gestational Diabetes". Diabetes Mellitus & Pregnancy - Gestational Diabetes. Armenian Medical Network. 2006. Retrieved 2007-02-28. Text " Carla Janzen, MD, Jeffrey S. Greenspoon, MD " ignored (help)
  2. Getahun D, Fassett MJ, Jacobsen SJ (2010). "Gestational diabetes: risk of recurrence in subsequent pregnancies". Am. J. Obstet. Gynecol. 203 (5): 467.e1–6. doi:10.1016/j.ajog.2010.05.032. PMID 20630491.
  3. 3.0 3.1 MacNeill S, Dodds L, Hamilton DC, Armson BA, VandenHof M (2001). "Rates and risk factors for recurrence of gestational diabetes". Diabetes Care. 24 (4): 659–62. PMID 11315827.
  4. Moses RG (1996). "The recurrence rate of gestational diabetes in subsequent pregnancies". Diabetes Care. 19 (12): 1348–50. PMID 8941462.

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