How GDM Affects Your Baby
Just like babies born to mothers with type 1 or type 2 diabetes, newborns from mothers with GDM can experience hypoglycemia at birth. Low levels of calcium and magnesium in your baby's blood may also be a problem, although uncommon. Jaundice, a yellowing of the skin that happens when your baby has excess bilirubin in her system, may also occur in GDM babies.
Fortunately, all of these conditions are usually easily correctable. And the fact that your GDM has been diagnosed means that your health care team can anticipate these possible problems and diagnose and treat them quickly. You may also have a neonatologist, a doctor who treats high-risk infants, in the delivery room to care for your baby if your physician foresees any problems.
Fact
Studies have shown that the diabetes drugs metformin and glyburide can be effective in controlling blood glucose levels in some women with GDM. However, more studies are needed to determine the long-range effects of these treatments. As of early 2008, no oral antidiabetic drugs were FDA-approved for use in pregnancy.
Fetal Macrosomia
Fetal macrosomia, or a baby who is too big for gestational age, can occur in women with GDM, especially if their blood glucose levels aren't well controlled. Since your blood glucose crosses the placenta and passes into the fetal circulation, your baby will start to produce more and more insulin to counteract its effects. Even the most active baby can't burn off all that glucose (there's only so much room to move around in there). As a result, the extra glucose is stored as fat.
We had our “birth plan” finished, but now that I have GDM, I'm thinking, Why bother?
Having GDM doesn't mean that all your wishes are automatically thrown out the window. A written agenda of what you want out of your labor and delivery may be even more important when you know interventions may be required. Your doctor can work with you to adjust your plan to reflect appropriate expectations. To learn more about birth plans, check out The Everything Pregnancy Book.
If an ultrasound reveals that your fetus is measuring substantially big for date, macrosomia may be suspected. If your child develops macrosomia, he may become too large to fit through the birth canal, and a C-section may be required. This is another reason that good control of your GDM is so important during pregnancy.
There is also a risk of macrosomia for women who deliver past thirty-eight weeks. For this reason, labor may be induced or a C-section may be scheduled at the 38th week of gestation. Talk with your doctor early about her thoughts on these interventions to work toward a birth experience that's acceptable for both of you and promotes the best possible outcome for your baby.
