Findings from a recent survey of new Oklahoma mothers found that almost one in 10 reported Gestational Diabetes Mellitus, or high blood sugar, during their pregnancy. GDM is associated with increased risks for lifelong poor health outcomes for mothers and infants, according to the Oklahoma State Department of Health.
For children of women with previous GDM, there is an increased risk of developing childhood obesity, prediabetes, and type 2 diabetes. Infants have increased risk of being very large at birth, which can cause problems at delivery for both mother and infant.
For mothers, GDM includes an increased risk of cesarean section delivery, more days in the hospital after delivery, and developing type 2 diabetes later in life. The risks were highest for mothers 30 years or older, those obese prior to becoming pregnant, women who have had a previous birth, and those women living in lower income households of less than $15,000 a year. Overweight or obese women with GDM had even greater risks for negative health outcomes.
Data from the survey also suggest increased costs for the health care system and the state as a whole as some women experiencing GDM and their offspring have complications and longer hospitalizations.
The Oklahoma State Department of Health offers these recommendations for health care providers as opportunities to decrease the number of women who develop GDM:
1. At annual women’s health visit, assess the family’s health behaviors and counsel on weight management, nutrition, physical activity, and ways to reduce the risk of obesity and type 2 diabetes.
2. Counsel women on the importance of the postpartum health checkup; schedule the postpartum visit with delivery provider or medical home at delivery discharge.
3. Provide diabetes management of blood glucose and blood pressure levels to help prevent complications during pregnancy, or refer women with GDM for appropriate diabetes management. Use a diabetes management team including certified nurse, nutrition and pharmacy educators, behavioral health specialists, and case management.
4. Counsel women on the benefits of breastfeeding for obesity prevention.
5. Adopt a Gestational Diabetes Screening Protocol for routine gestational diabetes screening at the first prenatal visit, the 24 to 28 weeks visit, postpartum visit, and women’s annual health visit. Recommended protocols are from the American Congress of Obstetrics and Gynecology and the American Diabetes Association.
6. Adopt the Institute of Medicine’s weight gain for pregnancy as protocol and assess weight gain at each prenatal visit. Women whose weight gain exceeds the medical standard should be counseled on appropriate weight gain and encouraged to sign a contract for behavioral changes including caloric balance, cardiovascular physical fitness, and stress reduction.
Survey data are part of the Pregnancy Risk Assessment Monitoring System, a surveillance system administered by the Oklahoma State Department of Health to monitor behaviors of women before, during and after pregnancy. On a monthly basis, PRAMS surveys between 200 and 250 mothers in Oklahoma. To read the entire PRAMS study, visit: http://www.ok.gov/health/documents/PramsGram_DIABETES_FEB_2012.pdf
For information about having a healthy baby, visit the “Preparing for a Lifetime, It’s Everyone’s Responsibility” website at: http://iio.health.ok.gov.