MATERNAL DIABETES* (GDM specifically)

Gestational diabetes mellitus (GDM) is a type of diabetes that develops during pregnancy, usually after 24 weeks of gestation, in women who did not have diabetes before becoming pregnant. Risk factors include obesity, advanced maternal age (being older during pregnancy), a family history of diabetes, a previous history of gestational diabetes, and having previously delivered a large baby (macrosomia – an unusually large baby). Good antenatal care (routine pregnancy healthcare) and regular blood glucose monitoring (blood sugar checks) are essential for early detection and proper management.

GDM can affect both the mother and the baby. In the mother, it increases the risk of preeclampsia (high blood pressure during pregnancy), infections, polyhydramnios (too much amniotic fluid around the baby), and the need for a Caesarean section (surgical delivery of the baby). In the baby, it can lead to macrosomia (an unusually large baby), neonatal hypoglycemia (low blood sugar after birth), polycythemia (an abnormally high number of red blood cells), jaundice (yellowing of the skin and eyes), and, in severe cases, stillbirth if the condition is not properly managed. Poorly controlled diabetes early in pregnancy is also associated with an increased risk of congenital anomalies (birth defects).

One important complication of GDM is Neonatal Respiratory Distress Syndrome (RDS) (difficulty breathing due to immature lungs). Although maternal glucose (blood sugar from the mother) crosses the placenta, maternal insulin does not. The excess glucose stimulates the fetal pancreas to produce large amounts of insulin (fetal hyperinsulinemia – abnormally high insulin levels in the baby), and these high insulin levels delay the production of pulmonary surfactant (a substance that keeps the air sacs in the lungs open). As a result, the baby's lungs may not expand properly after birth, leading to breathing difficulties. Maintaining good blood glucose control throughout pregnancy significantly reduces these risks.