• High maternal sugar levels in pregnancy can result in a larger than average baby. The increase in fetal size can cause such complications as prolonged labor, birth injury, or the need for cesarean delivery.



• Increased amniotic fluid is a common finding in gestational diabetes, although the cause isn't well known. It can lead to an overdistended uterus, which can make pregnancy more uncomfortable and sometimes cause contractions.



• Stillbirth, the most dreaded complication of pregnancy, is rare, but it is more likely to occur in a diabetic pregnancy in which blood sugars require insulin for control, or if blood sugars run chronically high during pregnancy. To prevent this devastating event, many specialists recommend delivery of gestational diabetic moms between 38 and 40 weeks gestation. Fetal monitoring near term can help assess the baby's well-being until labor or induction of labor begins.



• Respiratory distress syndrome, or RDS, which most commonly affects premature infants, is somewhat more likely in babies of diabetic mothers. For any given gestational age, diabetics' babies tend to have delayed lung maturity. This usually is treatable but may require transfer to a newborn intensive care unit. Most diabetics' babies who are born full term don't experience RDS.



• Maintaining blood sugar levels after birth can be a problem for some infants of diabetic mothers. If the baby got used to the delivery of a lot of sugar via the placenta, the absence of sugar can cause his blood glucose level to drop precipitously. Blood sugar levels under 35 are abnormal in a full-term newborn and can lead to long-term serious problems if not treated appropriately. Infants born to diabetic women normally have their blood tested a few times after birth and should be encouraged to take the breast or a bottle immediately after birth so as not to become hypoglycemic.

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