Texas Tech: Ignoring gestational diabetes puts unborn baby at risk

Gestational diabetes, a condition that develops in pregnant women who have never before had diabetes, does not harm the pregnant woman at all. However, it can have devastating consequences for the unborn child.

“Gestational diabetes has no signs and no symptoms in the mother,” says Dr. Randall Kelly, professor of OB/GYN at Texas Tech University Health Science Center at the Permian Basin. “It doesn’t affect her blood vessels, brain, heart or stomach. But it can do really bad things to the fetus.”

Dr. Kelly, head of the division of maternal-fetal medicine at Texas Tech at the Permian Basin, deals with perinatology, or high-risk obstetrics. The worst-case scenario for babies when gestational diabetes goes unchecked is stillbirth, he says.

Other complications may include the following:

1. Hypoglycemia — The baby’s pancreas has been producing too much insulin to cope with the sugar from the mother’s diet. When the sugar supply is cut off, the pancreas in the newborn is still geared up, sometimes producing low blood sugar in the newborn. “I’ve see babies stop breathing because their blood sugar was too low,” Dr. Kelly says.

2. Hypocalcemia, low blood calcium — If the gestational diabetes condition wasn’t diagnosed or wasn’t treated, the baby may develop a condition that doctors refer to as “lazy baby.”

“The baby is floppy, has poor muscle tone and doesn’t suck well,” Dr. Kelly says

3. Liver damage — A newborn liver may not metabolize bilirubin properly, resulting in an excess of bilirubin. The baby’s skin can turn yellow, and seizures and/or mental retardation may result.

4. Renal vein thrombosis — A blood clot develops in the vein that drains blood from the kidney of the newborn. Numerous problems can result.

5. Respiratory distress syndrome — “I’ve seen babies that weighed eight and a half pounds, whose lungs acted like premature lungs,” Dr. Kelly says. “They may need to be put on the ventilator immediately.”

6. Extra large babies — Babies born to mothers with gestational diabetes are often very large, which can lead to a C-section. Otherwise, the baby’s shoulder may get stuck in the birth canal, leading to further complications.

Fortunately, gestational diabetes can be diagnosed and controlled. Nowa-days, mothers are routinely tested for gestational diabetes during the second trimester of pregnancy. The test involves having the mother drink a sugary solution after breakfast or lunch, and taking a venous blood sugar test.

If the blood sugar level is above a certain number after proper testing, the woman is treated for gestational diabetes.

Diet is key to controlling gestational diabetes. The patient consults with a registered dietician to determine what is a healthy diet for her to maintain.

Dr. Kelly pleads with mothers not to cheat on their diets. He puts one fist on top of another and squeezes them to his chest to imitate a baby cringing inside when the mother’s blood sugar is too high.

“This is the baby when mom has that piece of pie,” he says. “Whatever the mom eats, the sugar comes right across the placenta to the baby. The baby’s pancreas has to work harder and grow larger to produce more insulin. This may impair the maturity of the baby’s other organs.”

He reassures moms-to-be that “Once the baby is born, the diabetes usually disappears completely, and you can usually eat anything you want.”

Dr. Kelly points out that Hispanic women in the Permian Basin have a greater chance for developing gestational diabetes than do Anglo women. The reason for this is unknown, but a genetic factor may be involved, he says.

Texas Tech Health Center is located at 701 W. 5th St. For information or to schedule an appointment, call (432) 335-5233.