How Does Gestational Diabetes Impact Your Labour?

Getting diagnosed with diabetes during pregnancy is a rather stressful situation for the mother and the fetus. Gestational diabetes, a condition that develops during pregnancy, can have a significant impact on labour and delivery.

However, according to a study submitted by the Cleveland Clinic, about 14% - 17% of pregnant women worldwide are diagnosed with gestational diabetes every year.

By making an effort to understand how it affects labour and proper management strategies, you can definitely reduce risks and ensure a safe and healthy delivery for both mother and child.

Gestational diabetes mellitus (GDM) is a condition where the body struggles to regulate blood sugar levels during pregnancy. Typically developing in the second or third trimester, it affects how the body’s cells use glucose.

If GDM is not managed, it can lead to complications such as high birth weight, preterm labour, and an increased risk of developing type 2 diabetes for both the mother and the baby. Early diagnosis and proper management are crucial for ensuring a healthy pregnancy and delivery.

Risk Factors and Diagnosis

Gestational diabetes occurs when the body is unable to produce enough insulin to regulate blood sugar levels during pregnancy. This condition can arise due to several factors, many of which are related to the body's changing demands and hormonal shifts.

While some women may be at higher risk due to pre-existing conditions or lifestyle factors, understanding the common causes of gestational diabetes is crucial for both prevention and management.

Risk Factors For Gestational Diabetes:

Hormonal changes during pregnancy affecting insulin regulation

Being overweight or obese before pregnancy

Lack of physical activity

Genetic predisposition or family history of diabetes

Polycystic ovarian syndrome (PCOS)

Age over 25 years

Previous pregnancy with gestational diabetes or a large baby

Excess weight gain during pregnancy

Diagnosis: Research shows that women who experienced GDM or had a large baby in a previous pregnancy are also at higher risk. Gestational diabetes is usually diagnosed through an Oral Glucose Tolerance Test (OGTT), typically performed between 24-28 weeks of pregnancy.

This test measures how well your body processes glucose after consuming a sugary drink. If blood sugar levels are higher than normal, it indicates gestational diabetes. Identifying these risk factors early allows for better management and reduces the likelihood of health challenges during pregnancy.
 

Gestational diabetes can significantly impact labour and delivery. Due to the condition, mothers are at a higher risk of complications, such as delivering larger-than-average babies (macrosomia), which can make vaginal delivery more difficult. 

As a result, doctors may recommend medical interventions like inducing labour to avoid potential issues, or even a cesarean section (C-section) if there are concerns about the baby’s size or the mother’s health. Proper management of gestational diabetes can help minimise these risks during delivery.

Increased Risk of Early Delivery

Women with gestational diabetes mellitus (GDM) are at a higher risk of experiencing preterm labour, often resulting in the baby being born before 37 weeks. Preterm babies may face several health challenges, such as respiratory distress syndrome due to underdeveloped lungs, low birth weight, and an increased risk of infection. Research by WHO shows that these complications are more common in babies born prematurely to mothers with GDM.

However, studies by the World Health Organization (WHO) also indicate that managing blood sugar levels through a balanced diet, regular exercise, and insulin (if necessary) can significantly reduce the risk of early delivery. Ensuring that GDM is well-managed throughout the pregnancy can help reduce the risk of preterm birth and lead to better health outcomes for both the mother and the baby.

Prolonged Labour

Gestational diabetes can also increase the likelihood of prolonged labour, primarily due to the larger size of babies, a condition known as macrosomia. Babies with macrosomia can weigh significantly more than average, which may lead to difficulties during vaginal delivery. 

This increased size can cause labour to progress more slowly or require additional medical interventions. Additionally, poorly managed blood sugar levels can affect labour, potentially making the process longer and more challenging.

According to the NHS, doctors closely monitor the labour progress of women with gestational diabetes to detect any signs of complications early. If issues arise, interventions such as assisted delivery or a cesarean section may be necessary. 

Actively managing gestational diabetes through proper diet, regular exercise, and medication can reduce the risk of prolonged labour and increase the chances of a smoother delivery. Preparation and careful monitoring are key to ensuring a safe outcome for both mother and baby.

For women with gestational diabetes, induction of labour or cesarean delivery may be recommended to reduce risks and ensure a safe delivery. If the baby is larger than average (macrosomia) or if there are concerns about maintaining healthy blood sugar levels during delivery, these interventions may become necessary. 

Inducing labour is often considered when it’s safer to deliver earlier, while a cesarean section may be required if the baby is too large for a safe vaginal birth. These decisions are made to minimise risks and ensure the best possible outcome for both mother and child.

Reasons for Induction and Cesarean Delivery

For women with gestational diabetes, the decision to induce labour or perform a cesarean section is often based on factors that prioritise the safety of both mother and baby. 

These interventions help manage risks associated with uncontrolled blood sugar levels or complications arising during delivery. Below are some of the key reasons for induction or cesarean delivery.

Induction may be recommended if:

• Labour does not begin naturally by 39-40 weeks.
• The baby shows signs of distress or abnormal growth.
• There are concerns about the mother's blood sugar levels and its effective management.

Cesarean delivery may be suggested in cases where:

• The baby is very large (macrosomia), making vaginal delivery difficult.
• There are complications during labour, such as prolonged labour or fetal distress.
• The mother has additional health concerns, such as high blood pressure, which can increase the risks during vaginal delivery.
   

If left unmanaged, gestational diabetes mellitus (GDM) can cause serious issues for both mother and baby. For the mother, it increases the risk of high blood pressure, preeclampsia, and the need for a cesarean section.

Babies born to mothers with uncontrolled GDM may develop macrosomia, which can lead to delivery challenges, including shoulder dystocia. They may also experience low blood sugar after birth, respiratory issues, or an increased risk of obesity and type 2 diabetes later in life. Proper management of GDM is essential to reduce these risks and ensure a healthy pregnancy and delivery.

Maternal and Fetal Complications

Gestational diabetes mellitus (GDM) can pose risks to both the mother and baby if not properly managed during pregnancy. Early diagnosis and careful blood sugar control are crucial to reducing them.

Maternal Complications:

• High blood pressure: GDM increases the risk of developing hypertension during pregnancy.
• Preeclampsia: A severe condition characterised by high blood pressure and potential organ damage.
• Increased risk of type 2 diabetes later in life: Women with GDM are more likely to develop type 2 diabetes post-pregnancy.

Fetal Complications:

• Macrosomia: Babies may grow larger than normal, leading to complications during delivery.
• Low blood sugar after birth: Newborns may experience hypoglycaemia, which requires immediate treatment.
• Higher chances of childhood obesity and type 2 diabetes: Children born to mothers with GDM have a higher risk of developing obesity and type 2 diabetes later in life.
   

Gestational diabetes treatment focuses on controlling blood sugar levels to ensure a healthy pregnancy and delivery. Key aspects include diet, exercise, blood sugar monitoring and medication. This approach helps reduce risks for both the mother and baby.

Gestational Diabetes Diet and Treatment

Treatment for gestational diabetes involves controlling blood sugar levels through a combination of a balanced diet, regular physical activity, and medical supervision. Proper management can reduce the risks and support a healthy pregnancy and safe delivery for both mother and baby.

Key treatment components include:

• Diet: A well-balanced diet with controlled carbohydrate intake, focusing on whole grains, vegetables, and lean proteins.
• Exercise: Regular physical activity, such as walking or swimming, helps regulate blood sugar.
• Blood Sugar Monitoring: Regular checks, often several times a day, to ensure levels remain within the target range.
• Medication: If diet and exercise are insufficient, insulin or other medications may be prescribed to manage blood sugar effectively.

Here’s a sample diet plan for managing gestational diabetes, tailored to our food habits. It is important to consult your doctor or nutritionist before making any dietary changes to ensure that they meet your specific health needs.
 

This plan incorporates recommendations from the Indian Council of Medical Research (ICMR) and emphasizes low glycemic index foods, which are beneficial in managing blood sugar levels. Always discuss your diet with your doctor to ensure it fits your gestational diabetes management plan and provides the right nutrition for you and your baby.
 

Gestational diabetes mellitus (GDM) is a prevalent pregnancy-related condition that demands careful monitoring and management to protect the health and well-being of both the mother and the baby. Without proper management, gestational diabetes can result in issues such as preterm labour, prolonged labour, or the necessity for a cesarean delivery due to macrosomia, where the baby grows larger than average.

However, by adopting a well-balanced diet, staying physically active, and closely monitoring blood sugar levels, these risks can be minimised. Consulting your doctor for personalised treatment plans is crucial. Early diagnosis and effective management not only ensure a healthy delivery but also reduce long-term risks for both mother and child.