Of all the medical tests expectant mothers undergo in the months before childbirth, perhaps one of the most important evaluates for gestational diabetes. This pregnancy-related condition—in which hormonal changes cause blood sugar levels to rise dangerously—is increasingly common, but moms-to-be can still take key steps to protect their health and that of their babies.
According to a 2016 report from the U.S. Centers for Disease Control and Prevention, as many as 9 percent of pregnant women are diagnosed with gestational diabetes. The condition used to be relatively uncommon, but the rate has risen dramatically in recent years.
To evaluate for gestational diabetes, women between the 24th and 28th week of pregnancy undergo a routine screening. This test is performed earlier in pregnancy if certain risk factors are present, inclusive of:
•African-American, Native-American, Asian-American, Hispanic or Pacific Islander ethnicity
•History of gestational diabetes
•Presence of obesity
•Prior delivery of a large infant (10 pounds or more)
•History of stillbirth
•Strong family history of diabetes
The test involves drinking a bottle of a glucose solution (called Glucola), and having blood drawn an hour later to analyze glucose levels. If a woman’s blood sugar is higher than 135 mg/dL, she’s referred for what’s called an oral glucose tolerance test—a more stringent screening involving an overnight fast, consuming another glucose solution and having blood drawn four times over three hours. An abnormal result confirms the diagnosis of gestational diabetes.
Gestational diabetes risks to mother and baby
Why is it important to test blood sugar levels during pregnancy? Because when levels rise and remain chronically high, gestational diabetes poses particular risks to both mom and baby.
Associated risks to the mother include the following:
•Pregnancy complications such as preeclampsia, a condition involving seriously high blood pressure that can harm both mother and child
•Premature delivery, particularly if gestational diabetes is diagnosed before 24 weeks’ gestation
•Delivering an overweight baby (more than 10 pounds), which raises the risk of requiring a cesarean birth
Associated risks to the baby include the following:
•Fetal death caused by the excessively high sugar levels in the mother’s blood
•Birth-related injuries caused by larger size
•Low blood sugar and electrolyte abnormalities in the neonate after birth
•Temporary respiratory problems in the newborn
•Jaundice or yellowing of the skin, which resolves with treatment
Unfortunately, not all risks to mom and baby from gestational diabetes disappear after childbirth. Half or more of women diagnosed with the condition during pregnancy will eventually develop type 2 diabetes. Research shows that children of women with gestational diabetes are at higher risks of developing type 2 diabetes.
Tips to control gestational diabetes
If you or a loved one has been diagnosed with gestational diabetes, there’s a lot that can be done to protect both mom’s and baby’s health despite the condition. Some cases can be managed without prescribing insulin. Implementation of regular exercise and dietary changes can effect good glucose control. Eating fewer sweets and smaller, more frequent meals can greatly affect blood sugar levels for the better.
Checking blood sugars regularly is an important tactic to ensure levels stay stable. Additionally, it’s important that you bring your sugar log to each prenatal visit, so your health provider can monitor your progress. If insulin is recommended by your doctor, make sure you take it as prescribed.
Kecia Gaither, M.D., MPH, FACOG, a perinatal consultant and women’s health expert, is a double board-certified physician in OB/GYN and Maternal-Fetal Medicine in New York City. www.keciagaither.com