How Is Your Baby Affected If You Are A Diabetic Who Is Pregnant?

Excerpts from the book.- A Simple Guide to Prevent Birth Defects authored by Dr. PremaLakshmi Narayana and Dr. C. VidyaShankar

The metabolic changes in a pregnant diabetic woman affect her reproductive outcome in many ways, from conception to delivery, and the effects may be felt by the baby soon after birth or even later. Diabetes may develop during pregnancy in a woman. This is called gestational diabetes.

A woman may already be a diabetic on treatment when she conceives. The effect on the fetus, the approach to management and preventive measures accordingly differs in the three groups.

Effects of maternal diabetes:

  • Congenital malformations (birth defects)
  • Large size at birth,
  • Dropping levels of blood sugar in the newborn baby with effects of hypoglycemia, like fits and shock.
  • Low calcium levels leading to tremors and fits,
  • Increased incidence of miscarriage, disability and death
  • Some of the drugs given for diabetes may cause birth defects in the fetus.

So pregnancy should always be a planned one in a diabetic woman.

Blood sugar levels should be brought under control before conceiving, as the formation of baby’s organs occur early, even before pregnancy is confirmed.  The formation of the body and organs may be adversely affected under abnormal blood sugar levels and while on oral drugs for diabetes.

The second group of women at risk are those who have a family history of diabetes, and are themselves likely to be undiagnosed diabetics. Women coming from such families should get investigated for diabetes before conceiving, to avoid defects coming in like a bolt from the blue.

The third group of women are healthy and have no family history of diabetes.  As diabetes is a common condition, and as it can affect anybody, it is ideal for all women to undergo tests to rule out diabetes before conceiving, so that they are not taken in by surprise after conceiving.

Incidence of birth defects like heart defects, cleft lip and palate, brain defects and multiple birth defects is 2 to 3 times more in a diabetic compared to a normal woman.

  • No woman should wait for diagnosing or managing diabetes till she knows that she has conceived, as by that time the critical period of formation of structures in the fetus are halfway through.
  • Besides a normal blood sugar level, the glycosylated haemoglobin level also should be normal before conceiving.
  • Folic acid supplementation is to be started before conceiving to prevent certain birth defects.
  • The consultant, once told of the plan to conceive, will suggest safer drugs, which will not affect the fetus.
  • Women who develop diabetes during pregnancy are generally better advised and managed if they have access to prenatal care and are also cooperative and follow the advice of their doctor.
  • Delivery should be conducted in a center where facilities are available for handling the problems in the newborn.