Consequences of Gestational Diabetes Mellitus for Mother and Baby

Maternal Consequences

The American College of Obstetricians and Gynecologists notes that gestational diabetes mellitus (GDM) is associated with increased frequency of preeclampsia and other hypertensive disorders during pregnancy, as well as increased cesarean delivery rates due to fetal growth disorders and alterations in obstetric management 1, 2
GDM increases the risk of diabetic ketoacidosis, particularly with poor glycemic control, according to the American Diabetes Association 3
Polyhydramnios, or excessive amniotic fluid, can develop due to fetal hyperglycemia and increased urination, as reported by the American College of Obstetricians and Gynecologists 1
The American College of Cardiology notes that women with GDM have an increased lifetime risk of cardiovascular events 2
Recurrence of GDM is more likely in subsequent pregnancies, with recurrence rates of 30-70%, according to the American Diabetes Association 4
Persistent hyperglycemia can occur in some women after delivery, as reported by the American College of Obstetricians and Gynecologists 4

The American Academy of Pediatrics notes that GDM increases the risk of macrosomia, or fetal overgrowth, with birth weights over 4000g 1
Birth injuries, including shoulder dystocia, brachial plexus injuries, and fractures, are more common in infants of mothers with GDM, according to the American College of Obstetricians and Gynecologists 5
Neonatal hypoglycemia can occur due to fetal hyperinsulinemia in response to maternal hyperglycemia, as reported by the American Academy of Pediatrics 1
Hyperbilirubinemia and jaundice are more common in infants of mothers with GDM, according to the American Academy of Pediatrics 1
Respiratory distress syndrome can occur in infants of mothers with GDM, despite lung maturity, due to insulin's effect on surfactant production, as reported by the American Journal of Obstetrics and Gynecology 3
Intrauterine fetal death can occur, particularly with severe hyperglycemia, as noted by the American College of Obstetricians and Gynecologists 1
Congenital anomalies can occur, primarily associated with pre-existing diabetes, but may also occur with early undiagnosed hyperglycemia, according to the American Diabetes Association 6
Hypertrophic cardiomyopathy can occur due to fetal hyperinsulinemia, as reported by the American Journal of Obstetrics and Gynecology 3

The American Heart Association notes that offspring of women with GDM have an increased risk of developing childhood obesity 7
Type 2 diabetes and prediabetes are more common in offspring of women with GDM, according to the American Diabetes Association 1
Cardiovascular disease risk is increased in offspring of women with GDM, as reported by the American Heart Association 3
Altered body composition, including increased adiposity and reduced fat-free mass, can occur in offspring of women with GDM, according to the American Diabetes Association 7

Preconception counseling is recommended for women with risk factors for GDM, as noted by the American College of Obstetricians and Gynecologists 6
Universal screening for GDM is recommended between 24-28 weeks of gestation using an oral glucose tolerance test, according to the American Diabetes Association 8
Postpartum screening with an OGTT at 4-12 weeks postpartum is recommended to identify persistent diabetes or prediabetes, as reported by the American College of Obstetricians and Gynecologists 8
Long-term follow-up with annual glucose testing is recommended for women with a history of GDM, according to the American Diabetes Association 8