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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 2 مورد

Potential risks associated with gestational diabetes mellitus

Potential risks associated with gestational diabetes mellitus
  Comment
Short-term
Hypertensive disorders of pregnancy (preeclampsia, gestational hypertension)
  • Preeclampsia can be life-threatening
  • These disorders often lead to medically-indicated preterm birth
Large for gestational age newborn or macrosomia
  • May result in maternal or neonatal birth trauma (eg, from shoulder dystocia)
  • Macrosomia is an indication for planned cesarean birth
Polyhydramnios
  • Usually mild
Operative delivery (cesarean birth, forceps- or vacuum-assisted vaginal birth)  
Fetal/neonatal cardiomyopathy
  • Usually asymptomatic, but 5 to 10% have respiratory distress or signs of poor cardiac output or heart failure
  • Most often in the setting of suboptimal glucose levels
Neonatal respiratory problems
  • Usually mild.
  • Most often in the setting of suboptimal glucose control. Fetal/neonatal hyperinsulinemia appears to delay surfactant synthesis.
Neonatal metabolic problems (hypoglycemia, hyperbilirubinemia, hypocalcemia, hypomagnesemia, polycythemia and hyperviscosity syndrome)
  • Most often in the setting of suboptimal glucose control
  • Hypoglycemia and hyperbilirubinemia are the most common metabolic problems
Longterm
Maternal
  • Diabetes mellitus (primarily type 2)
  • The lifetime maternal risk for diabetes is estimated to be 50 to 60%
  • Cardiovascular disease
  • Individuals with GDM are at higher risk of developing cardiovascular disease and developing it at a younger age than those with no history of GDM
Offspring
  • Diabetes mellitus
  • Obesity
  • Hypertension
  • Metabolic syndrome
  • Possibly adverse neurodevelopment
  

The risks of these outcomes increase as maternal fasting plasma glucose levels increase above 75 mg/dL (4.2 mmol/L) and as the one- and two-hour oral glucose tolerance test values increase from the lowest septile to the highest. This is a continuous effect; there is no clear threshold that defines patients at increased risk of adverse obstetric outcome.

The small increase in congenital anomalies observed in some population-based studies of GDM is likely related to undiagnosed preexisting type 2 diabetes mellitus or maternal obesity.

GDM: gestational diabetes mellitus.
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