Gestational diabetes natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Complications

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. 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.

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.

For Mother

• Hypertension
• Preeclampsia
• Increased risk for developing type 2 diabetes. High blood sugar (glucose) levels often go back to normal after delivery. However, women with gestational diabetes should be watched closely after giving birth and at regular doctor's appointments to screen for signs of diabetes. Many women with gestational diabetes develop diabetes within 5 - 10 years after delivery. The risk may be increased in obese women.

For Baby

• 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

Prognosis

Gestational diabetes generally resolves once the baby is born. However, women diagnosed with gestational diabetes have an increased risk of developing diabetes mellitus in the future. Women requiring insulin to manage gestational diabetes have a 50% risk of developing diabetes within the next five years.