Gestational Diabetes and Pregnancy: What you need to know

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Gestational diabetes mellitus or GDM is one of the most common diet-related complications during pregnancy. It only happens during pregnancy. It means you have high blood sugar levels, but those levels were normal before you were pregnant.

In gestation, the placenta produces hormones that help the baby to grow and develop. These hormones also block the action of the insulin, which is the hormone that helps to keep glucose (or blood sugar) at normal levels. This is called insulin resistance. Because of this insulin resistance, the need for insulin in pregnancy is 2 or 3 times higher than normal. If the body is unable to produce this much insulin, gestational diabetes develops.

 

If you have it, you can still have a healthy baby with help from your doctor and by doing simple things to manage your blood sugar, also called blood glucose.

 

It is most commonly diagnosed around the third trimester (usually around the 24th to 28th week of pregnancy) and in most of the cases goes away once the baby is born. Gestational diabetes makes you more likely to develop type 2 diabetes, but it won’t definitely happen.

WHO ARE AT GREATER RISK?

It affects between 2% and 10% of pregnancies each year. Women who are at greater risk of developing gestational diabetes are:

  • Mothers who are over 25 years of age
  • Having a family history of type 2 diabetes
  • Were overweight before you got pregnant
  • Women from certain ethnic backgrounds including Vietnamese, Chinese, middle eastern, Polynesian or Melanesian.
  • Women who have had gestational diabetes
  • Women who have had large babies or obstetric complications
  • Have given birth to a baby that was stillborn or had certain birth defects            
  • A woman who has had a polycystic ovarian syndrome

Gestational Diabetes Symptoms

Women with gestational diabetes usually have no symptoms. Most learn they have it during routine pregnancy screening tests.

Rarely, especially if the gestational diabetes is out of control, you may notice: 

  • Feeling more thirsty
  • Feeling more hungry and eating more
  • A need to pee more

Gestational Diabetes Treatment

To treat your gestational diabetes, your doctor will ask you to:

  • Check your blood sugar levels four or more times a day.
  • Do urine tests that check for ketones, which mean that your diabetes is not under control
  • A balanced diet is key to properly managing gestational diabetes. In particular, women with gestational diabetes should pay special attention to their carbohydrate, protein, and fat intake.
  • Eat a healthy diet that’s in line with your doctor’s recommendations
  • Make exercise a habit

Your doctor will track how much weight you gain and let you know if you need to take insulin or other medicine for your gestational diabetes.

Why Is Managing Blood Sugar Especially Important for Pregnant Women With Gestational Diabetes?  

Most women who develop diabetes during pregnancy go on to have a healthy baby. Dietary changes and exercise may be enough to keep blood sugar (glucose) levels under control, though sometimes you may also need to take medication.

But untreated gestational diabetes can cause serious problems. If blood sugar levels remain elevated, too much glucose ends up in the baby’s blood. When that happens, the baby’s pancreas needs to produce more insulin to process the extra sugar.

Too much blood sugar and insulin can make a baby put on extra weight, which is stored as fat. This can make the baby grow very large (macrosomia).

Also, high blood sugar levels during pregnancy and labor increase the risk of a baby developing low blood sugar (hypoglycemia) after delivery. That’s because the baby’s body produces extra insulin in response to the mother’s excess glucose. Insulin lowers the amount of sugar in the blood.

The signs and symptoms of hypoglycemia in an infant include:

  • jitteriness
  • weak or high-pitched cry
  • floppiness
  • lethargy or sleepiness
  • breathing problems
  • skin that looks blue
  • trouble feeding
  • eye rolling
  • Seizures

A baby may also be at higher risk for breathing problems at birth, especially if blood sugar levels aren’t well controlled or the baby is delivered early. (If you have gestational diabetes, your baby’s lungs tend to mature a bit later). The risk of newborn jaundice is higher too.

If your blood sugar control is especially poor, the baby’s heart function could be affected as well, which can contribute to breathing problems. Gestational diabetes sometimes thickens a baby’s heart muscle (hypertrophic cardiomyopathy), causing the baby to breathe rapidly and not be able to get enough oxygen from her blood.

Can gestational diabetes be prevented?

It’s not possible to prevent gestational diabetes entirely. However, adopting healthy habits can reduce your chances of developing the condition. If you’re pregnant and have one of the risk factors for gestational diabetes, try to eat a healthy diet and get regular exercise. Even light activity, such as walking, may be beneficial.

If you’re planning to become pregnant in the near future and you’re overweight, one of the best things you can do is work with your doctor to lose weight. Even losing a small amount of weight can help you reduce your risk of gestational diabetes.

 

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

 

Pregnancy, Fever, and Autism

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Fevers during pregnancy are never normal, so an exam is always recommended. Luckily, if the fever was caused by a viral illness, hydration and Tylenol are usually enough for recovery. But if the cause is bacterial, an antibiotic is often needed. Pregnant women should not take aspirin or ibuprofen.

The next important step is uncovering the cause of the fever. A fever during pregnancy is often a symptom of an underlying condition that could potentially be harmful to your growing baby.

What could be causing my fever during pregnancy?

When you’re pregnant, your immune system is doing double duty trying to protect both you and baby, so you may be more susceptible to colds and fevers during pregnancy.

When should I go to the doctor with my fever during pregnancy?

If your fever doesn’t go away in 24 to 36 hours, you should see your doctor. Also, you should go to the doctor if you experience any of these signs with your fever: abdominal pain, nausea, contractions or a rash. Your fever could be a symptom of other conditions like cytomegalovirus, flu, cold, food poisoning, HIV/AIDS, IBD, syphilis, toxoplasmosis or varicella.

How will a fever affect my baby?  

If an expectant mother’s body temperature goes from 98.6 degrees to a fever, it’s a sign that she is fighting an infection. That’s why it’s essential to seek treatment right away.

A new study done on animal embryos does show a link between fever early in pregnancy and an increased risk of heart and jaw defects at birth. Further research is needed to establish whether fever itself and not the infection causing it, increases the risk of birth defects in humans.

If you are in your first trimester and have a fever higher than 102 degrees, be sure to seek treatment right away. This may help prevent short- and long-term complications for your developing baby.

Fevers are often caused by urinary tract infections and respiratory viruses, but other infections could also be to blame. Having fever and other infections are very risky for the baby and may cause birth defects. According to one new study involving fever during pregnancy suggests that women who had a fever while pregnant had twice the risk of their baby having autism.

Scientists suspect that aside from a faulty gene or genes might make a person more likely to develop autism when there are also other factors present, such as a chemical imbalance, viruses or chemicals, or a lack of oxygen at birth. In a few cases, an autistic behavior is caused by Rubella (German measles) in the pregnant mother.

One of the most frustrating things about Autism, of course, is that we really don’t know what causes it. Researchers have identified certain risk factors, and many other potential causes have been identified (and left wanting for scientific evidence).

The findings mesh with other research linking diabetes and obesity during pregnancy to a higher risk of having a child with a developmental delay or autism. The two conditions – fever and diabetes – are associated with an inflammatory response in the body that researchers say may injure the developing brain. The study did not show an elevated risk of having a child with autism if mothers had the flu. But a fever from any cause, such as a bacterial infection, during pregnancy, was twice as likely to be described by mothers with children with autism and 2.5 times more likely in mothers of children with developmental delays.

Mothers who took anti-fever medication had the same risk of having a child with autism as mothers who reported no fever, the study found.

The fever study raises the question of whether chemicals the body releases to fight infection, called cytokines, may pass through the placenta and have a damaging effect on the fetus, said Ousseny Zerbo, lead author of the study, who was a doctoral candidate with UC Davis when the study was conducted.

Zerbo said cytokines are produced during acute inflammation that occurs when someone has a fever. The chemicals are also produced steadily in people with diabetes, who have a 2.3 times higher risk of having a child with developmental delays

Don’t worry too much, however, as the chances you’ll be in that situation are slim and a lot more research still needs to be done before any definitive conclusions can be drawn. Bottom line: Prevention and swift treatment are your best defense against fevers during pregnancy — and any concerns you may have.

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The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Resources:

http://www.amazingpregnancy.com/blog/pregnancy-fever-and-autism.html

http://www.mychildwithoutlimits.org/understand/autism/what-causes-autism/

 

Thyroid Disease & Pregnancy

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Thyroid disease is a group of disorders that affect the thyroid gland. The butterfly-shaped thyroid gland is located at the front of the neck. It makes hormones responsible for metabolism and brain function, as well as a number of other bodily functions, even the way your heart beats.

 

Sometimes the thyroid makes too much or too little of these hormones. Too much thyroid hormone is called hyperthyroidism and can cause many of your body’s functions to speed up. “Hyper” means the thyroid is overactive. Too little thyroid hormone is called hypothyroidism and can cause many of your body’s functions to slow down. “Hypo” means the thyroid is underactive.

 

What role do thyroid hormones play in pregnancy?

Thyroid hormones are crucial for the normal development of your baby’s brain and nervous system. During the first trimester, the first 3 months of pregnancy, your baby depends on your supply of thyroid hormone, which comes through the placenta. At around 12 weeks, your baby’s thyroid starts to work on its own, but it doesn’t make enough thyroid hormone until 18 to 20 weeks of pregnancy.

Two pregnancy-related hormones, human chorionic gonadotropin (hCG) and estrogen, cause higher measured thyroid hormone levels in your blood. The thyroid enlarges slightly in healthy women during pregnancy, but usually not enough for a healthcare professional to feel during a physical exam.

Thyroid problems can be hard to diagnose in pregnancy due to higher levels of thyroid hormones and other symptoms that occur in both pregnancy and thyroid disorders. Some symptoms of hyperthyroidism or hypothyroidism are easier to spot and may prompt your doctor to test you for these thyroid diseases.

 

Hyperthyroidism in Pregnancy

What are the symptoms of hyperthyroidism in pregnancy?

Some signs and symptoms of hyperthyroidism often occur in normal pregnancies, including faster heart rate, trouble dealing with heat, and tiredness.

Other signs and symptoms can suggest hyperthyroidism:

  • Fast and irregular heartbeat
  • Shaky hands
  • Unexplained weight loss or failure to have normal pregnancy weight gain
  • Feeling too hot
  • Increased sweating
  • Trembling hands
  • Tiredness/fatigue
  • Irritability and anxiety
  • Eye problems, such as irritation or discomfort
  • Menstrual irregularities
  • Infertility

 

What causes hyperthyroidism during pregnancy?

Hyperthyroidism in pregnancy is usually caused by Graves’ disease and it’s an autoimmune disorder. With this disease, your immune system makes antibodies that cause the thyroid to make too much thyroid hormone. This antibody is called thyroid stimulating immunoglobulin, or TSI.

Graves’ disease may first appear during pregnancy. However, if you already have Graves’ disease, your symptoms could improve in your second and third trimesters. Some parts of your immune system are less active later in pregnancy so your immune system makes less TSI. This may be why the symptoms improve. Graves’ disease often gets worse again in the first few months after your baby is born, when TSI levels go up again. If you have Graves’ disease, your doctor will most likely test your thyroid function monthly throughout your pregnancy and may need to treat your hyperthyroidism. Thyroid hormone levels that are too high can harm your health and your baby’s.

How can hyperthyroidism affect me and my baby?

Untreated hyperthyroidism during pregnancy can lead to

  • miscarriage
  • premature birth
  • low birthweight
  • preeclampsia—a dangerous rise in blood pressure in late pregnancy
  • thyroid storm—a sudden, severe worsening of symptoms
  • Congestive heart failure

Rarely, Graves’ disease may also affect a baby’s thyroid, causing it to make too much thyroid hormone. Even if your hyperthyroidism was cured by radioactive iodine treatment to destroy thyroid cells or surgery to remove your thyroid, your body still makes the TSI antibody. When levels of this antibody are high, TSI may travel to your baby’s bloodstream. Just as TSI caused your own thyroid to make too much thyroid hormone, it can also cause your baby’s thyroid to make too much.

An overactive thyroid in a newborn can lead to

  • a fast heart rate, which can lead to heart failure
  • early closing of the soft spot in the baby’s skull
  • poor weight gain
  • Irritability

 

How is hyperthyroidism diagnosed?

Your doctor will perform a physical examination and order blood tests to measure your hormone levels. You have hyperthyroidism when the levels of T4 and T3 are higher than normal and the level of TSH is lower than normal. To determine the type of hyperthyroidism you have, your doctor may do a radioactive iodine uptake test to measure how much iodine your thyroid collects from the bloodstream. The thyroid uses iodine to make T3 and T4. Your doctor may also take a picture of your thyroid (a thyroid scan) to see its shape and size and to see whether there is any nodules present.

 

How do doctors treat hyperthyroidism during pregnancy?

If you have mild hyperthyroidism during pregnancy, you probably won’t need treatment. If your hyperthyroidism is more severe, your doctor may prescribe antithyroid medicines, which cause your thyroid to make less thyroid hormone. This treatment prevents too much of your thyroid hormone from getting into your baby’s bloodstream. Doctors most often treat pregnant women with the antithyroid medicine propylthiouracil  (PTU) during the first 3 months of pregnancy. Another type of antithyroid medicine, methimazole, is easier to take and has fewer side effects, but is slightly more likely to cause serious birth defects than PTU. Birth defects in either type of medicine are rare. Sometimes doctors switch to methimazole after the first trimester of pregnancy. Some women no longer need antithyroid medicine in the third trimester.

 

Hypothyroidism in Pregnancy

What are the symptoms of hypothyroidism in pregnancy?

Symptoms of an underactive thyroid are often the same for pregnant women as for other people with hypothyroidism. Symptoms include

  • extreme tiredness
  • trouble dealing with cold
  • muscle cramps
  • Severe constipation
  • problems with memory or concentration
  • Weight gain (only 5–10 pounds or 2–4 kg)
  • Dry skin and hair
  • Constipation
  • Menstrual irregularities

Most cases of hypothyroidism in pregnancy are mild and may not have symptoms.

What causes hypothyroidism during pregnancy?

Hypothyroidism in pregnancy is usually caused by Hashimoto’s disease and occurs in 2 to 3 out of every 100 pregnancies.1 Hashimoto’s disease is an autoimmune disorder. In Hashimoto’s disease, the immune system makes antibodies that attack the thyroid, causing inflammation and damage that make it less able to make thyroid hormones.

How can hypothyroidism affect me and my baby?

Untreated hypothyroidism during pregnancy can lead to

  • preeclampsia—a dangerous rise in blood pressure in late pregnancy
  • Anemia
  • miscarriage
  • low birthweight
  • stillbirth
  • Congestive heart failure, rarely

In adults, untreated hypothyroidism leads to poor mental and physical performance. It also can cause high blood cholesterol levels that can lead to heart disease. A life-threatening condition called myxedema coma can develop if severe hypothyroidism is left untreated.

Diagnosis of hypothyroidism is especially important in pregnancy. Untreated hypothyroidism in the mother may affect the baby’s growth and brain development.

All babies are tested at birth for hypothyroidism. If not treated promptly, a child with hypothyroidism could have an intellectual disability or fail to grow normally.

 

 How do doctors treat hypothyroidism during pregnancy?

Treatment for hypothyroidism involves replacing the hormone that your own thyroid can no longer make. Your doctor will most likely prescribe levothyroxine, a thyroid hormone medicine that is the same as T4, one of the hormones the thyroid normally makes. Levothyroxine is safe for your baby and especially important until your baby can make his or her own thyroid hormone.

Your thyroid makes a second type of hormone, T3. Early in pregnancy, T3 can’t enter your baby’s brain like T4 can. Instead, any T3 that your baby’s brain needs is made from T4. T3 is included in a lot of thyroid medicines made with animal thyroid, such as Armour Thyroid, but is not useful for your baby’s brain development. These medicines contain too much T3 and not enough T4, and should not be used during pregnancy. Experts recommend only using levothyroxine (T4) while you’re pregnant.

Some women with subclinical hypothyroidism—a mild form of the disease with no clear symptoms—may not need treatment.

If you had hypothyroidism before you became pregnant and are taking levothyroxine, you will probably need to increase your dose. Most thyroid specialists recommend taking two extra doses of thyroid medicine per week, starting right away. Contact your doctor as soon as you know you’re pregnant.

Your doctor will most likely test your thyroid hormone levels every 4 to 6 weeks for the first half of your pregnancy, and at least once after 30 weeks.1 You may need to adjust your dose a few times.

 

If you have thyroid problems, you can still have a healthy pregnancy and protect your baby’s health by having regular thyroid function tests and taking any medicines that your doctor prescribes.

 

Thyroid Disease and Eating During Pregnancy

What should I eat during pregnancy to help keep my thyroid and my baby’s thyroid working well?

Because the thyroid uses iodine to make thyroid hormone, iodine is an important mineral for you while you’re pregnant. During pregnancy, your baby gets iodine from your diet. You’ll need more iodine when you’re pregnant—about 250 micrograms a day. Good sources of iodine are dairy foods, seafood, eggs, meat, poultry, and iodized salt—salt with added iodine. Experts recommend taking a prenatal vitamin with 150 micrograms of iodine to make sure you’re getting enough, especially if you don’t use iodized salt. You also need more iodine while you’re breastfeeding since your baby gets iodine from breast milk. However, too much iodine from supplements such as seaweed can cause thyroid problems. Talk with your doctor about an eating plan that’s right for you and what supplements you should take.

 

 

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

 

Resources:

https://www.niddk.nih.gov/health-information/endocrine-diseases/pregnancy-thyroid-disease