Diabetes is the most common medical complication of pregnancy, affecting 2 to 3% of all pregnancies. Ten percent of cases are women who have diabetes before pregnancy, and for these women, the risk of birth defects is four times greater than in women who get diabetes during pregnancy (gestational diabetes).
The most common birth defects resulting from a diabetic woman becoming pregnant are problems with the structure of the baby's heart, spine or kidneys. These outcomes are especially true if the mother has high blood sugars prior to conceiving. Women with pre-pregnancy diabetes are also at higher risk of out-of-control diabetes during pregnancy, which can lead to an increased risk of stillbirth.
Careful management of diabetes before conception is critical. Women who have normal blood sugars before and when they conceive experience lower risks for birth defects. The risk can even be lowered to near the level of a non-diabetic woman.
Ninety percent of the cases involving diabetes during pregnancy are classified as gestational diabetes. This is diabetes that is diagnosed or recognized during a pregnancy. Since it develops after the baby's organs are formed, the risk of birth defects does not increase. Women with gestational diabetes, however, do experience greater incidences of excessive baby growth before birth. This can lead to delivery problems or the need for a cesarean section. Controlling sugars during pregnancy can lower the risk.
Women with diabetes receive care through the Diabetes in Pregnancy Program at Cedars-Sinai. Our Maternal-Fetal Medicine specialists and certified nurse educator teach each woman how to control her blood sugar. Our nurse educator uses a special diabetic diet for pregnancy (not a weight-reduction diet), and teaches each woman to track her sugars with a home monitor. The patient reviews her sugar log with the nurse at least once every week. As necessary, the Diabetes in Pregnancy Program staff recommends modified diets or medications.
Patients and referring physicians appreciate our intensive, compassionate approach to managing diabetes in pregnancy, which significantly improves the results of pregnancies that are complicated by this relatively common problem.