Gestational diabetes, pregnancy and your pēpi
You are considered to have a higher risk pregnancy if you have gestational diabetes. If you can keep your blood glucose levels within the target range recommended by your gestational diabetes team there is less risk of complications.
Pregnancy complications with gestational diabetes
If you have raised blood glucose levels with gestational diabetes it means you have a greater chance of developing complications in pregnancy.
Gestational diabetes (internal link)
Preeclampsia
Preeclampsia only happens in pregnancy. It can cause:
- high blood pressure
- protein in your wee (urine)
- swelling of your hands and feet.
You and your pēpi can become unwell so we monitor you both closely, usually in hospital.
Polyhydramnios
Polyhydramnios is when there is too much amniotic fluid (the fluid around your pēpi). Extra fluid causes discomfort and can lead to early birth (before your due date) and the umbilical cord coming out before pēpi.
Caesarean section
There is a higher chance of needing a caesarean section if your pēpi grows too big, which can happen with gestational diabetes.
Caesarian section (internal link)
Induction of labour
Induction of labour to deliver your pēpi before your due date may be recommended if you have gestational diabetes.
Gestational diabetes and your pēpi
Following the recommended management plan for gestational diabetes means you are more likely to have a healthy pēpi.
If you have gestational diabetes, you are at higher risk of your pēpi developing problems. The most common is a large pēpi.
Large size happens because the high blood glucose levels are passed on to the pēpi in the womb. The extra glucose is stored by the pēpi as body fat and the extra insulin causes pēpi to grow more. The pēpi may have a harder birth due to their size.
With high insulin levels, pēpi can also become unwell in late pregnancy — so we take extra care to check the wellbeing of the pēpi.
The extra insulin made by the pēpi means they may have:
- very low blood glucose levels after birth
- a higher risk of breathing problems and jaundice.
Your maternity team will check the blood glucose level of your pēpi after birth. Hospitals are prepared to handle any problems if they happen, but good blood glucose control in pregnancy is the key to avoiding these problems.
Risk of diabetes for your pēpi
Your pēpi is not born with diabetes, but diabetes tends to run in whānau. If you had gestational diabetes, your tamaiti may be more at risk to develop diabetes later in life.
When blood glucose levels remain high in pregnancy, pēpi become tamariki with an increased risk of obesity and, later on, type 2 diabetes. To lower this risk, make sure your tamaiti:
- has a healthy diet
- has regular exercise
- maintains a healthy weight.
Managing your blood glucose levels during pregnancy creates a healthy environment for your pēpi to grow in the womb.
Gestational diabetes can affect future pregnancies
If you have had gestational diabetes you are very likely develop it in future pregnancies.
If you lose weight between pregnancies and keep your weight in the target range for your height you can reduce the risk of gestational diabetes in your next pregnancy. You will still need an HbA1c test for gestational diabetes at your early pregnancy appointment.
Risk of diabetes for you
After your pēpi is born there is a good chance your diabetes goes away. It is very important to have a follow up blood glucose test (the HbA1c test) at 10 to 12 weeks after you give birth. Your diabetes midwife will request this test and your healthcare provider will follow up the result.
Some hospitals in Aotearoa New Zealand find 25% to 30% of women with gestational diabetes have prediabetes (borderline diabetes) when tested 3 months after giving birth.
There is still a chance that even if you have no diabetes after giving birth, you go on to develop it later in life. Diabetes can develop as you grow older and particularly if your weight increases. It is best to get an HbA1c test every year with your healthcare provider.
Your risk of developing diabetes can be lowered by:
- eating a healthy diet
- doing regular exercise
- keeping to the correct weight for your height.
Your lead maternity carer or diabetes midwife may refer you for an individual consultation to help you develop a healthy living plan.