Impact of gestational diabetes mellitus in maternal and fetal health: An update

Abstract

In recent years, there has been an increased incidence of gestational diabetes (GDM), defined as any degree of glucose intolerance with the onset or first recognition during pregnancy with or without remission after the end of pregnancy. The most significant risk factors are: age >25 years, obesity, high parity, family history of DM, past history of GDM or macrosomic infant. GDM therapy should be based on a healthy diet, exercising and glycemic control, with or without insulin. The presence of GDM has important implications for both the baby and the mother. As regard baby complications, GDM is associated with a significantly increased risk of macrosomia, shoulder dystocia, birth injuries as well as neonatal hypo glycemia and hyperbilirubinemia, genetic risk for the development of obesity, diabetes and/or metabolic syndrome in childhood. As regard mother complications, GDM is a strong risk factor for the development of permanent diabetes later in life (40% in 10 subsequent years) and GDM in successive pregnancies (35%), stress urinary incontinence and mixed urinary incontinence, doubled risk for overactive bladder during premenopausal period, cardiovascular morbidity. This review briefly examine the risk factors, diagnostic criteria, best therapy and management, short and long term complications for the mother and the fetus associated with such pathology.

Life Experience of Pregnant Woman with Gestational Diabetes Mellitus in Maternal Role Attainment in Special Region of Yogyakarta

“…Because the glucose can diffuse through the placenta to the fetus, so the level in fetal blood is almost like the maternal blood levels. Mother insulin cannot reach the fetus, so the mother's blood sugar levels affect fetal blood levels (Alia et al, 2019;Plows et al, 2018).…”

“…Failure to recognize and deal with these conditions will result in unwanted morbidity in multiple pregnancies, while overly aggressive management will result in the emergence of intervention is not required. Infants of diabetic mothers have unique problems and require special handling (Alia et al, 2019). One previous study showed that babies born to mothers with a history of DM revealed an increase in the Sectio Caesarean delivery and preterm births (Joy & Sivakumar, 2012).…”

“…The frequency of fetal death in utero or stillbirth ranged from 15-20%. An attempt to avoid the sudden death of the fetus in the womb is to terminate the pregnancy a few weeks before term (Alia et al, 2019).…”

“…Various efforts have been done for mother and the fetus to achieve good condition and wellbeing. The experience of mothers to keep a longer pregnancy is to maintain fetal maturity by way of check-ups to the hospital (Alia et al, 2019). Another effort made by mothers is doing movement exercises during pregnancy, doing routine blood sugar control and continuously making efforts for healthcare treatment (Alia et al, 2019;Dhingra & Ahuja, 2016).…”

“…An important intervention on long-term metabolic benefits for both mother and offspring has been attributed to breastfeeding. In the offspring, a protective role was seen against excessive fat accumulation, protection against childhood infections, cardiovascular diseases and type 2 diabetes, while in women an association between lactation and low concentrations of glucose and insulin and a better tolerance to glucose was seen and a significant delay in the appearance of type 2 diabetes in women with GDM (Alia et al, 2019).…”