How blood sugar reaches the baby, possible effects of gestational diabetes on mother and baby, and how the glucose test is done.
In the video, Prof. Dr. İkbal Kaygusuz explains that good nutrition is an important modifiable factor in pregnancy. She notes that eating well lowers the likelihood of problems such as gestational diabetes, high blood pressure in pregnancy, pre-eclampsia, preterm birth and blood clots. While little can be done before birth for most structural anomalies found in the womb, she points out that the risk of these complications can be reduced.
In pregnancy, a physiological insulin resistance develops in the mother so that nutrients reach the baby. Other nutrients cross to the baby through a controlled mechanism, but there is no mechanism limiting the passage of glucose; when the mother's blood sugar stays high, the sugar passes directly to the baby, and the baby's pancreas produces more insulin. The video lists the possible consequences:
- The baby growing large, especially around the shoulders, thickening of the heart muscle and delayed lung development; these babies may be more likely to need intensive care.
- A greater need for caesarean section with large babies; in vaginal birth, use of a vacuum, a larger episiotomy or tears, and difficulty delivering the shoulders, with possible nerve injury or a broken collarbone.
- After a prolonged labour, the uterus failing to contract adequately and bleeding after birth.
- Low blood sugar (hypoglycaemia) and jaundice in the baby after birth.
Gestational diabetes is diagnosed with a glucose tolerance test between weeks 24 and 28. There are different ways of doing the test: in one, blood sugar is checked one hour after drinking a 50 g glucose drink; if it is high, a 100 g test follows, and the diagnosis is made if two of the four values are high. In the video, she says that in her own practice a 75 g test is done at the week-24 check-up after a fasting blood sample, with two further samples taken one hour apart.
A common question is whether the sugary drink harms the baby. If the values are normal, the drink can be said to have no adverse effect; if they are high, this shows that blood sugar is not being balanced in everyday eating either, and making the diagnosis matters. The video notes that 75 g of glucose is about 300 calories, roughly two slices of baklava, and that this one-off test is considered reasonable.
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