Gestational diabetes and the neonate: challenges and solutions

Abstract

The prevalence of gestational diabetes mellitus (GDM) is rising worldwide, along with overweight and obesity. In utero exposure to hyperglycemia increases perinatal complica-tions including preterm birth, macrosomia, neonatal respiratory distress, hypoglycemia, and polycythemia. More significantly, GDM places the offspring at risk of insulin resistance and type 2 diabetes mellitus, obesity and cardiovascular disease. The relative contributory roles of the intrauterine environment, shared genes, and postnatal environment on long-term outcomes are not yet fully understood. Maternal obesity in particular remains a significant confounding factor. Opportunities for ameliorating both the perinatal effects and long-term and intergenera-tional effects of GDM exist at the level of prevention of GDM, screening for and treatment of GDM, and postnatal interventions in offspring.