Impact of gestational diabetes mellitus in maternal and fetal health: An update

Abstract

In recent years, there has been an increased incidence of gestational diabetes (GDM), defined as any degree of glucose intolerance with the onset or first recognition during pregnancy with or without remission after the end of pregnancy. The most significant risk factors are: age >25 years, obesity, high parity, family history of DM, past history of GDM or macrosomic infant. GDM therapy should be based on a healthy diet, exercising and glycemic control, with or without insulin. The presence of GDM has important implications for both the baby and the mother. As regard baby complications, GDM is associated with a significantly increased risk of macrosomia, shoulder dystocia, birth injuries as well as neonatal hypo glycemia and hyperbilirubinemia, genetic risk for the development of obesity, diabetes and/or metabolic syndrome in childhood. As regard mother complications, GDM is a strong risk factor for the development of permanent diabetes later in life (40% in 10 subsequent years) and GDM in successive pregnancies (35%), stress urinary incontinence and mixed urinary incontinence, doubled risk for overactive bladder during premenopausal period, cardiovascular morbidity. This review briefly examine the risk factors, diagnostic criteria, best therapy and management, short and long term complications for the mother and the fetus associated with such pathology. *Correspondence to: Andrea Ciavattini, Department of Clinical Sciences, Unit of Obstetrics and Gynecology Università Politecnica delle Marche, Via Corridoni, 60124 Ancona, Italy, Tel: +39 071 596 2053; E-mail: a.ciavattini@univpm.it