Babies Born to Diabetic Mothers

Introduction

Diabetes mellitus is a health condition where the body cells are unable to utilize the blood sugar for its energy sources. This results in an overload of blood sugar or glucose in the bloodstream. This excess of glucose in the bloodstream may damage the heart, kidneys, nerves, and eyes. Diabetes is a gradually increasing medical condition worldwide, especially gestational diabetes. Gestational diabetes in pregnant women is growing drastically due to lifestyle and food habits changes. This gestational diabetes causes not only maternal health problems but also the newborn. Therefore, glycemic levels are regularly monitored during pregnancy.

What Is the Reason Behind Diabetes?

Food is a rich source of carbohydrates; our body breaks them into glucose. This glucose gets circulated in the bloodstream for utilization by the cells for energy. Insulin is a hormone secreted by the pancreas. This insulin acts as a signal for the cells to utilize this circulating blood glucose for energy production. Diabetes is when there is a deficiency in insulin production or an inability to use them. If the cells do not take up glucose, blood sugar levels remain elevated, resulting in diabetes.

What Causes Diabetes During Pregnancy?

During pregnancy, the placenta nourishes the baby with nutrients and water and produces various hormones. These hormones play a significant role in making the pregnancy viable. Some of the hormones are:

• Estrogen.

• Cortisol.

• Human placental lactogen.

These hormones block insulin. As the placenta grows, it produces more hormones and causes more insulin resistance. Usually, the body produces more insulin to meet its opposition, but if insulin production is deficient due to placental hormones, it results in gestational diabetes. If the pregnant woman already has diabetes, more insulin may be required as the pregnancy continues.

What Are the Types of Diabetes That Occur in Pregnancy?

During pregnancy, there are chances for two types of diabetes. First, as we know of the term gestational diabetes, there is another term, “pregestational diabetes.”

• Gestational Diabetes: This is when the mother acquires diabetes during pregnancy. This may be due to the changes in their hormones which result in insulin resistance.

• Pregestational Diabetes: Refers to a diabetic woman who becomes pregnant.

What Are the Risk Factors for Gestational Diabetes?

• Pregnancy above 25 years.

• Obese patients.

• Previous history of gestational diabetes.

• Family history of diabetes.

• Any history of miscarriages or stillbirth.

• Natives of African Americans, Asian Americans, Latinas, Hispanics, or Pacific Islanders.

How Does Maternal Diabetes Affect the Child’s Growth?

Many pregnant women may wonder how diabetes affects their pregnancy, and many are unaware of the complications. For example, suppose the mother’s glycemic levels are higher during pregnancy. In that case, the excess amount of blood glucose is transferred to the body, which makes the baby secrete more insulin resulting in increased tissues and fat deposits. So the babies born to diabetic mothers are generally more significant than the others.

What Are Some of the Symptoms of a Newborn to Diabetic Mothers?

• Congenital disabilities or miscarriages are likely to happen in pregestational mothers.

• Lethargy, weak cry, poor sucking, and puffy face.

• High blood pressure.

• Poor lung development results in breathing problems and nervous system development.

• High levels of red blood cells and thickened blood.

• High bilirubin levels (newborn jaundice) due to increased levels of red blood cells.

• Thickening of heart muscles between the chambers.

• These babies are prone to diabetes and obesity at later ages.

What Are the Characteristics of Newborns to Diabetic Mothers?

• Macrosomia: It is the most typical complication of gestational diabetes. These babies have birth weights above 4000 to 4500 grams. This is due to excess secretion of insulin resulting in excess fat deposition.

• Preterm Babies: There is an increased risk for preterm babies. This is still not apparent, but it may be because the babies are overweight. Therefore, early labor is induced to decrease the risk of fetal death and other birth complications.

• Hypertrophic Cardiomyopathy: It is also a cardiac malformation. Maternal hyperglycemia and hyperinsulinemia result in hypertrophic cardiomyopathy, where the interventricular septum gets affected. In severe cases, it may spread to the myocardium.

• Cardiac Malformations:

  1. Transposition of Great Arteries: The two main arteries, the aorta, and pulmonary artery, carrying blood from the heart, are switched in their position.

  2. Double Outlet of the Right Ventricle: The aorta connects incorrectly.

  3. Ventricular Septal Defects: There is a hole present in the ventricular septum.

  4. Truncus Arteriosus: Is a congenital disability where the blood vessels leaving the heart fail to separate and remain fused.

  5. Hypoplastic Left Heart Syndrome: The left side of the heart does not form properly.

  6. Brachial Plexus Injuries: Sometimes, birth trauma may cause spinal cord injuries resulting in brachial plexus palsies.

How Are the Characteristics of Newborns to Diabetic Mothers Managed?

1. Monitoring Blood Glucose Levels: Blood is drawn from the heel stick, a needle placed in the arms, or an umbilical catheter.

2. Checking For Hypoglycemia:

• Feeding immediately after birth may prevent low glucose levels or hypoglycemia.

• In some hospitals, if breast milk is inadequate, Dextrose gel is kept inside the baby's cheek as an alternative to formula milk.

• If the blood glucose level does improve even after feeding, fluid containing glucose and water is given through an intravenous route.

• In severe cases where the baby’s glucose requirement is more, glucose fluid is given through the umbilical vein near the belly button.

3. Respiratory Support: In the case of breathing difficulties, oxygen is given through a breathing machine.

Conclusion

Diabetes may cause several health problems, but if the glycemic levels are within the normal range, it does not cause severe problems. However, if a person is diagnosed as diabetic, especially during pregnancy, proper health advice should be taken from the doctor. Simple lifestyle changes such as diet, exercise, and yoga can help to keep blood glucose levels within the normal range. Throughout the pregnancy, a diabetic mother's fetus (baby) may be exposed to high blood sugar (glucose) levels and other nutrients. Diabetic mothers' infants are frequently larger than other babies, especially if diabetes is poorly treated. This may make vaginal birth more difficult and raise the risk of nerve damage and other birth trauma. Cesarean deliveries are also more common. In addition, regular prenatal visits and monitoring glucose levels and insulin therapies can prevent health complications for the mother and baby.