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Pregnancy and Diabetes

Pregnancy and Diabetes

  • Pregnancy and Diabetes
  • Caesarean Delivery Linked to Increased Risk of Childhood Obesity and Type 1 Diabetes. Rates of caesarean section are rising; repeat caesarean and maternal request contribute to this increase. Data linking caesarean delivery to chronic disease is observational. An adjusted analysis found caesarean delivery increased the relative risk of childhood type 1 diabetes by 19%, as well as increased risks of obesity and asthma. Unless medically indicated, researchers believe possible child health risks should be considered before performing a caesarean section. Source: Blustein J, et al. Time to consider the risks of caesarean delivery for long term child health. BMJ. 2015;350:h2410. http://www.bmj.com/content/350/bmj.h2410
  • Exercise Helps Prevent Gestational Diabetes and Reduce Weight Gain During Pregnancy. Gestational diabetes can have long-term effects on the mother, such as impaired glucose tolerance and type 2 diabetes. Children whose mothers had gestational diabetes are more likely to become overweight or obese, therefore increasing their risk of developing diabetes. More than 2800 pregnant women in Spain who did little or no exercise were enrolled into exercise programs. Analysis of 13 trials showed that exercise reduced the risk of gestational diabetes more than 30%. Source: Diesel JC, et al. Moderate exercise helps prevent gestational diabetes and reduces weight gain during pregnancy. BJOG. 3 June 2015. http://www.bjog.org/details/news/8003811/Moderate_exercise_helps_prevent_gestational_diabetes_and_reduces_weight_gain_dur.html
  • Women Delivering Males More Likely to Develop Gestational Diabetes. It is believed gestational diabetes occurs due to a combination of metabolic abnormalities in the mother and temporary metabolic changes that happen during pregnancy. Researchers analyzed insurance records of almost 643,000 women from Ontario delivering their first child between April 2000 and March 2010 for the rate of diabetes cases. Women having boys were more likely to develop gestational diabetes. Women who developed gestational diabetes and had a girl were more likely to develop type 2 diabetes. Findings suggest carrying a male creates greater pregnancy-associated metabolic changes. Sources: Retnakaran R. Fetal sex and the natural history of maternal risk of diabetes during and after pregnancy. JCEM. 20 May 2015. http://press.endocrine.org/doi/10.1210/jc.2015-1763 Mothers of sons more likely to develop diabetes during pregnancy. MedicalXpress. 20 May 2015. http://medicalxpress.com/news/2015-05-mothers-sons-diabetes-pregnancy.html
  • Take-home Points. The increased risk of developing childhood obesity, asthma, and type 1 diabetes should be considered before performing a non-medically necessary caesarean section. Exercise was shown to help prevent the risk of gestational diabetes and reduce weight gain in pregnancy, conditions which could result in long-term impaired glucose tolerance and type 2 diabetes. Women delivering sons are more likely to develop gestational diabetes, suggesting carrying male fetuses could lead to greater metabolic changes during pregnancy.

A 2014 study by the Centers for Disease Control estimates gestational diabetes rates are as high as 9.2% annually in the US. Women with gestational diabetes are at a high risk of developing pregnancy and delivery complications and experience a 7-fold increased risk of developing type 2 diabetes later in life. Children of mothers with gestational diabetes are more likely to develop impaired glucose tolerance and metabolic complications.

We present 3 recent studies that discuss the topics of pregnancy and diabetes and ways to potentially reduce the risk of diabetes for both the mother and child.

Source: DeSisto CL, et al. Prevalence estimates of gestational diabetes mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007–2010. Prev Chronic Dis. 2014;11:130415.

Additional Sources:

Blustein J, et al. Time to consider the risks of caesarean delivery for long term child health. BMJ. 2015;350:h2410.

Diesel JC, et al. Moderate exercise helps prevent gestational diabetes and reduces weight gain during pregnancy. BJOG. 3 June 2015.

Retnakaran R. Fetal sex and the natural history of maternal risk of diabetes during and after pregnancy. JCEM. 20 May 2015.

Mothers of sons more likely to develop diabetes during pregnancy. MedicalXpress. 20 May 2015.

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Dr. Tonni Bacoat-Jones

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