The babies born to mothers with gestational diabetes are prone to be bigger in size, a condition known as fetal macrosomia. This affects both the mother and the fetus and even lead to obesity at a later stage.
When is a baby considered to be big in size?
If the weight of the baby is 4.5kg or more at the time of birth, then the baby is considered to be larger than normal. This is also known as ‘fetal macrosomia’ and is large for gestational age (LGA). Large for gestational age generally refers to a birth weight equal to or more than the 90th percentile for a given gestational age. There is an association of fetal macrosomia with a higher likelihood of obstetric and neonatal complications.
Can gestational diabetes affect the size of a baby?
Yes. A review of maternal and fetal growth factors in diabetic pregnancy states that gestational diabetes affects up to 4% of pregnancies. And it is associated with fetal macrosomia. Another research suggested that there is an association between abnormal maternal glucose tolerance and children’s higher BMI and overweight risk from 1 to 6 years of age.
Also, children who have higher birth rate have higher risk of being overweight during adolescence.
Similarly, if a child is born to a mother with gestational diabetes, there is a risk of increased adolescent overweight.
The results of a study suggest there may be a causal role of altered maternal-fetal glucose metabolism in the obesity among kids. Also, the postnatal insult due to GDM can be a risk marker or a cause of obesity. Moreover, this change in glucose metabolism during type 1 diabetes may also lead to a larger baby at birth.
How does fetal macrosomia affect the baby or the mother?
Fetal macrosomia may affect 12% of newborns of normal women. Whereas it can affect 15-45% of newborns of women with gestational diabetes. The increased insulin resistance of the mother is the primary risk factor for macrosomia in gestational diabetes. In such cases, an excessive amount of blood glucose passes through the placenta into the fetal circulation. It causes extra glucose in the fetus, which stores as body fat and leads to macrosomia.
Fetal macrosomia is a common adverse infant outcome of Gestational Diabetes Mellitus if unrecognized and untreated in time. For the infant, macrosomia can increase the risk of various problems, such as shoulder dystocia, clavicle fractures and brachial plexus injury. This also increases the admission rate to the neonatal intensive care unit.
Additionally, the mother can also face an increased susceptibility to cesarean delivery, postpartum hemorrhage and vaginal lacerations. Also, overweight babies are at an increased risk of becoming overweight or obese at a young age. They are more likely to develop type II diabetes later in life.
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