Diabetes Pregnancy Complications and Concerns

1. Preeclampsia (gestational hypertension or high blood pressure). Women with Type 1 are predisposed to this because they often have higher blood pressure to begin with.

2. Insulin resistance. During pregnancy, the placenta supplies a growing fetus with nutrients and water and produces hormones to maintain the pregnancy. In early pregnancy, hormones can cause increased insulin secretion and decreased glucose production by the liver, which can lead to hypoglycemia (low blood glucose). In later pregnancy, some hormones (estrogen, cortisol and human placental lactogen) can have a blocking effect on insulin, a condition called insulin resistance. As the placenta grows, more hormones are produced, and insulin resistance becomes greater.

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3. Worsening diabetes complications. Any health issues with organs, glands, or your nervous system may worsen during pregnancy due to the increased difficulty of keeping blood glucose in the target range.

4. Macrosomia. Women with diabetes are more likely to have a larger-than-average baby.

5. Issues during delivery. This is often due to the larger size of the baby, sometimes necessitating a caesarean section or early inducement of delivery. A larger baby may also run the risk of shoulder dystocia, in which the shoulders of the baby fail to pass the pubic symphysis.

6. Birth defects. Largely the result of blood sugar levels that aren’t in target safe ranges, these include respiratory distress syndrome (RDS), cardiovascular issues, and problems affecting development of the brain, spine, kidneys, gastrointestinal tract, limbs, and mouth.

7. Miscarriage (loss of the baby before 20 weeks gestation) or stillbirth (after 20 weeks). This may be due to possible birth defects caused by excessive sugar in the blood.

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