Baby Your Baby: Diabetes in pregnancy

Baby Your Baby - Diabetes in pregnancy
Uncontrolled diabetes increases a pregnant woman's risk of having a baby with a birth defect. Al Romeo, RN with Utah Department of Health's MotherToBaby program, says every woman starts out with a 3% to 5% chance of having a baby with a birth defect but uncontrolled diabetes increases that risk. Diabetes is one of the most common risks for birth defects.

Women with diabetes should work with their provider to control their diabetes before they get pregnant. Mom’s healthcare provider will test her Hemoglobin A1C to see if it is within the normal range. Keeping the A1C in the normal range during the pregnancy will reduce the risks. Some of the birth defects associated with uncontrolled diabetes include birth defects in the spine, heart, bones, urinary tract, reproductive tract, and digestive system.

Other risks include greater risk for miscarriage, stillbirth, pre-eclampsia, and polyhydramanios (too much fluid around the baby). At birth, babies born to moms with diabetes are at greater risk for being large (sometimes more than 10 pounds), having breathing difficulties, jaundice, and low blood sugar.

Not every woman with uncontrolled diabetes will have a baby with a birth defect but the risk increases from that baseline of about 5% to about 20% for very poorly controlled diabetes. During pregnancy, mom’s healthcare provider may recommend different tests, such as an ultrasound and echocardiogram to look at her baby’s heart, to determine if the baby is developing properly. Insulin is commonly used to control diabetes during pregnancy and the insulin does not increase the risks for birth defects.

Gestational diabetes usually develops later in pregnancy, after those structures like the heart are already formed, so there is less of a risk for birth defects if a woman develops gestational diabetes in pregnancy. But it still needs to be controlled well to prevent the other problems that baby could have at birth such as breathing problems.

During breastfeeding, moms should also control their diabetes to help with milk production and to prevent hypoglycemia or low blood sugar, in their baby.

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