Early Detection: Gestational Diabetes & Preeclampsia

Chances are you'll sail through pregnancy without trouble. But even if you're feeling great, you should still seek regular prenatal care because some health problems that could hurt your baby are symptomless. These include gestational diabetes, which raises blood sugar levels during pregnancy, and preeclampsia, a form of high blood pressure. But with early detection and treatment, you can manage these problems and still have a healthy baby.

What Is It?

Gestational diabetes occurs when pregnancy hormones interfere with the body's ability to use insulin, the hormone that turns blood sugar into energy, resulting in high blood sugar levels. Each year, 2 to 5 percent of women develop this serious illness in pregnancy.

While most women with gestational diabetes have no symptoms, a small number may experience extreme hunger, thirst, or fatigue.

How Do I Know If I Have It?

Your doctor will probably screen you for gestational diabetes between your 24th and 28th weeks of pregnancy. If you have certain risk factors (see "Who's at Risk?" below), your doctor may opt to screen you sooner. During your screening, you'll drink a sugary liquid, then take a blood test. If your blood sugar levels appear high, you'll need to take a longer test, during which you'll drink more liquid and your blood sugar will be tested several times to determine whether you have gestational diabetes.

What Are the Risks Associated with It?

Women who fail to seek treatment for gestational diabetes run the risk of giving birth to big babies (9 pounds or more), since much of the extra sugar in the mother's blood ends up going to the fetus. Larger babies are more likely to suffer birth injuries during vaginal delivery, as they're more apt to get stuck in the birth canal. Because of this, large babies are often delivered by c-section, and they have an increased risk of developing breathing difficulties and jaundice as newborns.

How Can It Be Treated?

Many women who develop this condition can control their blood sugar levels with diet and exercise. Your doctor or dietitian may design an individualized diet that takes into account your weight, stage of pregnancy, and food preferences. Of this diet, 10 to 20 percent of your calories should come from protein, 30 percent from fats, and the remainder from complex carbohydrates such as whole-grain breads or cereals. If you've been on the diet for two weeks and your blood sugar level hasn't returned to normal, you may need to take insulin shots for the rest of your pregnancy.

Studies have found that women who develop gestational diabetes may also be at risk of developing preeclampsia, though the reason is still unknown.

Who's at Risk?

You may be more likely to develop gestational diabetes if:

• You are over 30 years of age.

• You are obese.

• You have a family history of diabetes.

• You have had gestational diabetes in a previous pregnancy (you have a 35 to 50 percent chance of developing it again).

• You previously gave birth to a baby who weighed more than 9 1/2 pounds.

• You have experienced a stillbirth.

• You are of African-American, Hispanic/Latino, Pacific Island, South or Eastern Asian, or Native American ancestry.

Preexisting Diabetes

One in 100 women develop diabetes before pregnancy. Unfortunately, women with poorly controlled preexisting diabetes are three to four times more likely than nondiabetic women to have babies with birth defects of the heart or neural tube. Women with preexisting diabetes also have an increased risk of miscarriage and stillbirth. Fortunately, you can significantly reduce these risks by controlling your blood sugar before pregnancy. If you have preexisting diabetes, speak with your doctor before you attempt to conceive.