Gestational diabetes mellitus (GDM) is carbohydrate intolerance, short of overt diabetes, diagnosed during pregnancy. GDM is associated with adverse pregnancy outcomes, such as fetal macrosomia with its attendant risks of birth injury during vaginal delivery, neonatal hypoglyce-mia, plethora and hyperbilirubinemia, excess fetal/neonatal fat deposition, childhood obesity, and disordered carbohydrate metabolism. Maternal problems include an increased risk of cesarean delivery and hypertensive disorders of pregnancy. Many of these adverse outcomes can be prevented or ameliorated by efforts to maintain maternal euglycemia. Various professional organizations recommend lifestyle modification including diet and exercise with self-glucose monitoring. If goals for glucose control are not met, an antidiabetic medication should be prescribed.
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