Mom’s gestational diabetes is an impartial threat issue for fetal hypoxia throughout labor

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In Finland, one in five mothers was diagnosed with gestational diabetes in 2019. The disease increases the mother’s risk of developing type 2 diabetes in the future. However, the most significant consequence of gestational diabetes is fetal macrosomia, or overgrowth of the fetus. Macrosomia increases birth injuries for both the infant and mother, causes fetal hypoxia, which is a lack of oxygen in the fetus, and increases labor-related complications in the newborn.

A research group at Helsinki University and Helsinki University Hospital showed that maternal gestational diabetes is an independent factor that increases the risk of fetal hypoxia during labor. The peer-reviewed study was published in Acta Diabetologica.

Another finding was that gestational diabetes increased the susceptibility of the fetus to intrapartum hypoxia regardless of the size of the fetus.

The risk of hypoxia, and the resulting risk of bad condition in newborns, was nearly seven-fold in fetuses from mothers with gestational diabetes compared to fetuses from non-diabetic mothers.

Mikko Tarvonen, researcher

According to the results, the risk of resuscitation of the newborn was ten times.

Hypoxia has short- and long-term effects on the fetus and the newborn and, in the worst case, can lead to brain damage and death of the fetus.

“Damage caused by hypoxia is a source of suffering for the child and family. In addition, the cost of treating hypoxia-related injuries to society is extremely high,” says Tarvonen.

Monitoring the fetal heart rate carries the risk of hypoxia

A lack of oxygen in the fetus can be determined by recording the fetal heart rate during labor. A zigzag pattern, which means increased variability in fetal heart rate, indicates the onset of hypoxia in both normal pregnancies and gestational diabetes.

Cardiotocography (CTG), or electronic monitoring of fetal heart rate and uterine contractions, is a routine precaution performed during childbirth for all hospital deliveries in Finland. Previously, diet-treated gestational diabetes was not an indication for continuous CTG monitoring during labor.

“Based on our results, increased CTG monitoring during labor is well indicated during labor in women with gestational diabetes. This would allow early detection of a zigzag pattern and ensure the safety of delivery and delivery, ”says Tarvonen.

Monitoring the fetal heart rate during labor also needs to consider the mother’s desires and experiences.

“CTG monitoring restricts the mother’s mobility a little during labor. On the basis of our findings, fetal monitoring could in future be geared more specifically to fetuses that would benefit from more precise monitoring, ”emphasizes Tarvonen.

“The treatment and monitoring of gestational diabetes is a multi-professional collaboration that focuses on the mother, fetus and child. Hopefully the new findings will improve birth safety – both in terms of preventing fetal hypoxia and strengthening the mother’s feelings. “Safety,” he adds.

Healthy lifestyle habits help prevent gestational diabetes

Obesity, sedentary lifestyle and an unhealthy diet are major risk factors for gestational diabetes. Previous research has shown that healthy lifestyle habits and maintaining good blood sugar levels can significantly reduce such risks during pregnancy.

“There are also women of normal weight with gestational diabetes who are likely to have a genetic predisposition. Nevertheless, they too benefit from sufficient physical activity and healthy lifestyle habits, ”adds Tarvonen.

Source:

Journal reference:

Tarvonen, M., et al. (2021) Intrapartum cardiotocographic patterns and hypoxia-related perinatal outcomes in pregnancies complicated by gestational diabetes mellitus. Acta Diabetologica. doi.org/10.1007/s00592-021-01756-0.