Gestational Diabetes REALLY high mortality rate? And immature lungs?

[Allie84]

I was just researching GD which I got diagnosed with and this link appears to say 16% of babies of mothers with GD die?! Am I reading this right.

A.Overall Gestation Diabetes Perinatal Mortality: 16.3%
B.Gestational DKA confers 50-80% perinatal mortality
II.Glucose Control related to perinatal mortality
A.American Study (1972)
1.Glucose <100: Perinatal mortality 3.4%
2.Glucose 101-150: Perinatal mortality 16%
3.Glucose >150: Perinatal mortality 24%
B.British Study (1965)
1.Glucose <150: Perinatal mortality 7.6%
2.Glucose 151-200: Perinatal mortality 21%
3.Glucose >200: Perinatal mortality 38%
What on earth does this mean? Surely 16% of all babies die from this....


https://www.fpnotebook.com/Endo/OB/GstnlDbtsPrntlMrtlty.htm

And then I came across this on another site...saying that if you have GD the baby's lungs don't mature until 38.5 weeks? I've never heard this.

The nondiabetic fetus achieves pulmonary maturity at a mean gestational age of 34-35 weeks. By 37 weeks' gestation, more than 99% of healthy newborn infants have mature lung profiles as assessed by phospholipid assays. However, in a diabetic pregnancy, the risk of respiratory distress may not pass until after 38.5 gestational weeks.

The majority of the literature indicates a signi&#64257;cant biochemical and physiologic delay in infants of diabetic mothers. Tyden et al[33] and Landon and colleagues[34] reported that fetal lung maturity occurred later in pregnancies with poor maternal glycemic control, regardless of class of diabetes.

https://emedicine.medscape.com/article/127547-overview#aw2aab6b7


My doctor has never mentioned anything like this. I'm just feeling so worried because I just had a blood sugar reading of 160.

 

[shellshocked]

Google will be every pregnant womans downfall.

IAMNAD nor do I have GD and this is my first pregnancy so no expert - but do have type 1 diabetes. A few high bloodglucose readings won't cause any problems. The idea is to get them as stable and as close to normal as possible.

The lung thing can be true but the same goes for type 1 diabetics ( I have this) diabetic mothers are often induced early at 38 weeks so cannot be too much of an issue. In addition to this drugs can be administered to help with lung development.

I have blood glucose readings of 160 (over 8mmol) a few times a week, when I last went in my endocrinologist and diabetes specialist MW told me I was doing well and my readings were good. Don't stress just look after yourself as best you can my overall Hba1c is much lower than that. Don't google for complications stress is awful for bloodglucose management- ask your doctor/midwife if you are worried. Certainly don't read up on things like that!! ( if the worst comes to the worst they'll put you on insulin) feel lucky we live at the time that we do and try and enjoy pregnancy (LOL wish I could take my own advice!) Goodluck and don't stress judging by the 100's of women in my specialist diabetic antenatal clinic (most are GD) its really really common and I've seen lots of lovely healthy babies been leaving with smiling Mums!

https://global.thebump.com/tickers/ttf5edc.aspx

 

[Springtime]

Those studies were done in 19602 and 1970s. Very old.
They might be true in the case of unregulated diabetes. But my nurse did mention death of a fetus fromGD is a very rare occurance.
Don't worry too much about it. Consistenty very high readings, over weeks, may be dagerous. But the occasional spurt is unlikely to do much harm.
The care is much better these days anyway.
If you are anxious, talk to your Obs next time you see him/her.

 

[vintage67]

Like other said, I've had high numbers throughout this pregnancy occassionally, but my overall averages have been good. That's what's important. I am a Type 2 this pregnancy and was GD during my first pregnancy. He was born at 38 weeks and his lungs were fine. He did have some hypoglycemia issues, which is common.

 

[Allie84]

Thank you everyone. I feel better...especially realizing the studies are quite old! When my blood sugar went to 160 yesterday I started Googling and that is NEVER a good idea. I see my doc tomorrow and I'm going to discuss how anxious I've been over the GD the past few weeks.

 

[vintage67]

I blame some of these doctors and even the diabetes educators. Some of these ob's really don't much about diabetes except for some guideline numbers on a piece of paper and they just send women into a panic. A newly diagnosed GD woman that I know actually called an ambulance to her house over a very high number, sure that she had killed her baby. It's insane.

I'm certainly not saying high numbers aren't something to be concerned about, but to see people panicing over a 140 or 160 kind of makes me sad.

My ob for my last pregnancy when I had GD was very hateful about numbers. And looking back, I realize that I did really well until about 3 weeks before the baby was born. And all he did was blame me, instead of increasing my insulin or empowering me with the knowledge to do so. My diabetes educator for that pregnancy was a quiet little woman that had probably never weighed more than 110 pounds her entire life, had no children and no one in her family had diabetes. She seemed really cluelesss about the day to day struggles of diabetes, or the strain of being pregnant.

This time has been very different. My ob is a Type 2 diabetic on an insulin pump, and my endocrinologist went into endocrinology because of all the diabetes in his family. Will they point out high numbers to me? Sure they will, but they actually offer strategies instead of blame, and reassure me how well I am doing overall.

 

[Tanikit]

I am also a type 1 diabetic. A once off high blood sugar is not going to harm your baby - I had at least one level of 21 in both my pregnancies (that is 378 in American measures) but once I knew I got it down as fast as I could. The idea is to keep your sugar levels as close to normal as possible. As type 1 diabetics we normally have more of a range than a GD will going from extre,e hypoglycaemia to higher levels than a GD would get. I think the treatment of babies born to diabetic mothers is better than it was in the past which also helps and mothers keep their sugars better controlled so you saying you had one level of 160 would be compared to someone who kept there levels around 160 or more all the pregnancy.

When I became diabetic in 1991 we did not have the machines to measure blood glucose that we have now - it took much longer to do and often we were not using a machine and just comapring colours on the end of a strip - things are far more accurate now and so you can have a better idea how you are doing.

Try not to worry. They should keep a close eye on you towards the end of the pregnancy doing stress tests and more constant check ups. If you are worried about anything you should phone and finally when your baby is born then its blood glucose should be checked for a few hours and treated if necessary (both my girls had hypoglycaemia after birth) They also usually induce diabetics at 38 weeks (and GDs often at 39 weeks) because this is the safest time - usually the lungs are mature and the placenta is still functioning ok. Babies can be treated as premature babies now even if born at 38 weeks if their lung function is not as good as it should be - remember that 95% of babies born post 32 weeks survive these days so having lungs a few weeks behind won't matter in a hospital that is on the ball.

 

[mwaah]

Try not to worry. The dr's made me worry at every appointment. Saying he was big, I'd have to have him at 37 weeks.
I was induced at 39 weeks and he wieghed 7lb 2oz. He was and is perfectly healthy.
On the plus side they made me worry about the sugar I ate so much that I only put on 9lbs the whole pregnancy and areally healthy.

Goodluck xx

 

[Rach27]

Stay away from Mr Google!!!

I had GD in my last pregnancy and was super scared at first about the risk of stillbirth. The diabetic nurse at the hospital scare-mongered me into thinking that if I didn't get induced at 38 weeks, my baby would die. I asked her how many times that had happened (if the mum was not induced early) and she said twice. After a battle with my consultant, I was finally induced at 39/5 and they monitored me up to that. My GD was controlled with diet, my baby was not big for gestation, my placenta was fine.

That went a bit off topic from your question but I am assuming those stats are old and relate more to extreme cases of uncontrolled diabetes in pregnancy.

They monitor you very closely towards the end of pregnancy so try not to worry.

 

[fairygirl]

I wouldn't worry, those studies are old and before gd was closely monitored. Interestingly my consultant looked at my monitoring and gave me a safe range of 4.8 - 8.5 (86 - 153 in US) which I think is true to my metabolism. Anything under 4.5 (81) which would be considered normal and I feel ill.

I have been told by a friend who had GD last year that they do prefer not to induce before 38 weeks due to lung issues. My consultant hasn't said anything about delivery yet. I'm managing my gd through diet and baby is small so I'm guessing they're gonna let me go to full term.

 

[vintage67]

They induced me at 38 weeks, but it wasn't just the GD. My blood pressure soared that week and I put on 20 pounds of fluid in 4 days! They did several ultrasounds to check the baby's lungs, but for my safety, he had to come out!

 

[Spunky]

I had GD (no meds or insulin) and i wasn't induced until 41+4, he was born 41+6. He had low blood sugar for a few hours despite skin-to-skin and frequent feedings but his blood wasn't circulating well yet (if this happens with next baby i am going to rub the hell out of their kegs and feet to increase blood flow). Once his feet pinked up his glucose level was great and there were no complications. My dates were not off and at 13 days late he was only 7 lbs 12oz. Those studies are old and medicine and monitoring has come a long way. h&h pregnancy to you