Brightening the Lives of Pregnant Women through Sunshine


Appropriate antenatal care is proven to play a crucial role in ensuring good outcome of the mother and the baby. Good antenatal care ensures periodic assessment of growth and development of the baby, and supplementation of additional nutrition required for the mother. It also provides prompt recognition of any complication that befall pregnancy, one such dreaded complication being gestational diabetes mellitus. Gestational diabetes mellitus (GDM) is defined as the carbohydrate intolerance of varying severity with onset or first recognition in pregnancy. The prevalence of GDM in India is around 3.8-21%, and it is seen more in urban women. Physical environment, ethnicity, genetics, dietary patterns, lifestyle, obesity, family history of diabetes mellitus, and history of GDM in the previous pregnancy are independent risk factors for the development of GDM.

Carbohydrate metabolism in pregnant women differs from the non-pregnant state, where there is an increased demand for metabolic fuel to compensate for fetal needs. To meet these requirements, placental hormones such as human placental lactogen, beta- hCG, and progesterone act on the body to increase peripheral resistance to insulin action, cause hypertrophy of the islets of Langerhans and hyperinsulinemia. Thus, fasting hypoglycemia and postprandial hyperglycemia are its unique features. When these changes to pathological state in pregnancy, it has various adverse effects on the mother and baby. Persistent hyperglycemia due to decreased uptake by the maternal tissues causes catecholamine release and vasoconstriction. This predisposes pregnant women to the development of hypertension, decreases placental perfusion and causes premature placental aging, intrauterine fetal growth restriction and has the potential for intrauterine fetal demise. The fetus also is at risk for birth injuries, and perinatal asphyxia, thereby increasing the perinatal morbidity and mortality. These babies should be screened for congenital heart diseases like ventricular and atrial septal defects. However, Gestational Diabetes Mellitus increases the risk of women developing Type II DM later in life.

Read More About This Article: 10.31031/IGRWH.2020.03.000573

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