Infant of diabetic mother

Definition

A fetus (baby) of a mother with diabetes may be exposed to high blood sugar (glucose) levels throughout the pregnancy.

Causes

There are two forms of diabetes during pregnancy:

If diabetes is not well controlled during pregnancy, the baby is exposed to high blood sugar levels. This can affect the baby and mother during pregnancy, at the time of birth, and after birth.

Infants of diabetic mothers (IDM) are often larger than other babies. This makes vaginal birth harder. This can increase the risk for nerve injuries and other trauma during birth. Also, cesarean births are more likely.

The IDM is more likely to have periods of low blood sugar (hypoglycemia) shortly after birth, and during first few days of life. This is because the baby has been used to getting more sugar than needed from the mother. They have a higher insulin level than needed after birth. Insulin lowers the blood sugar. It can take days for babies' insulin levels to adjust after birth. 

IDMs are more likely to have:

Chances of miscarriage or stillborn child are higher in women with poorly controlled diabetes.

IDM has higher risk of birth defects if the mother has pre-existing diabetes that is not well controlled from the very beginning. 

Symptoms

The infant is often larger than usual for babies born after the same length of time in the mother's womb (large for gestational age). In some cases, the baby may be smaller (small for gestational age).

Other symptoms may include:

Exams and Tests

Before the baby is born:

After the baby is born:

Treatment

All infants who are born to mothers with diabetes should be tested for low blood sugar, even if they have no symptoms.

If an infant had one episode of low blood sugar, tests to check blood sugar levels will be done over several days. Testing will be continued until the infant's blood sugar remains stable with normal feedings.

Efforts are made to ensure the baby has enough glucose in the blood:

Rarely, the infant may need breathing support or medicines to treat other effects of diabetes. High bilirubin levels are treated with light therapy (phototherapy).

Outlook (Prognosis)

In most cases, an infant's symptoms go away within hours, days, or a few weeks. However, an enlarged heart may take several months to get better.

Very rarely, blood sugar may be so low as to cause brain damage.

Possible Complications

The risk of stillbirth is higher in women with diabetes that is not well controlled. There is also an increased risk for a number of birth defects or problems:

When to Contact a Medical Professional

If you are pregnant and getting regular prenatal care, routine testing will show if you develop gestational diabetes.

If you are pregnant and have diabetes that is not under control, call your provider right away.

If you are pregnant and are not receiving prenatal care, call a provider for an appointment.

Prevention

Women with diabetes need special care during pregnancy to prevent problems. Controlling blood sugar can prevent many problems.

Carefully monitoring the infant in the first hours and days after birth may prevent health problems due to low blood sugar.


Review Date: 12/13/2017
Reviewed By: Kimberly G. Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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