Patient's question:
Hello, I didn't have diabetes before. I discovered high blood sugar during pregnancy and later found out it was gestational diabetes. I didn't pay much attention to it, just reduced my intake of sweet foods, but I still ate a lot. The child passed away shortly after birth due to oxygen deprivation, distress, being a macrosomia, and having some deformities. There is no family history of diabetes, and I was in good health. I weighed 143 pounds before pregnancy and 165 pounds at 39 weeks. Could the child's death and deformities be directly related to diabetes?Doctor's answer:
(1) The incidence of neonatal respiratory distress syndrome increases. Persistent hyperglycemia in pregnant women reaches the fetus through the placenta, stimulating increased fetal insulin secretion, leading to hyperinsulinemia. This condition counteracts the role of glucocorticoids in promoting the synthesis and release of surfactant by type II alveolar cells, resulting in reduced production and secretion of fetal lung surfactant, which delays fetal lung development.(2) Neonatal hypoglycemia. After the newborn is separated from the maternal hyperglycemic environment, hyperinsulinemia persists. If glucose is not supplemented in a timely manner, neonatal hypoglycemia may occur, which can be life-threatening in severe cases.
(3) Hypocalcemia and hypomagnesemia. Normal newborns have blood calcium levels of 2-2.5 mmol/L. Blood calcium levels below 1.75 mmol/L within 72 hours after birth are considered hypocalcemia. The lowest blood calcium levels occur between 24 and 72 hours after birth. The incidence of hypocalcemia in newborns of diabetic mothers is 10%-15%. Some newborns also develop hypomagnesemia (normal newborns have blood magnesium levels of 0.6-0.8 mmol/L, and levels below 0.48 mmol/L within 72 hours after birth are considered hypomagnesemia).
(4) Others: The incidence of conditions such as hyperbilirubinemia and polycythemia is higher in newborns of diabetic mothers compared to those of normal pregnancies.