Apart from cases associated with polycystic ovary syndrome, gestational diabetes does not directly reduce the patient’s fertility. However, gestational diabetes increases the chances of adverse pregnancy outcomes for the mother and the baby. The risk of stillbirth is also increased. However, most mothers with gestational diabetes have a healthy pregnancy.
The onset of gestational diabetes also means a higher risk of developing obesity and type 2 diabetes, with their specific adverse effects on health and fertility. The risk of developing type 2 diabetes depends on the severity of gestational diabetes and required therapy. Women requiring insulin to manage gestational diabetes have a 50% risk of developing diabetes within the next five years. Up to two third of women will re-experience gestational diabetes in future pregnancies. The risk of re-experiencing gestational diabetes also grows with the patient’s age, the number of pregnancies and the weight gained in between pregnancies.
The main diabetes type 2 complication related to pregnancy is (similarly to gestational diabetes) macrosomia - or a big baby (higher than the 90th percentile in birth weight). Sometimes these babies are not able to pass through the birth canal, so there are higher incidences of caesarean sections, and sometimes it is necessary to induce labor early. Fetal distress can also become an issue. There is also an increased risk of birth defects. This condition is directly related to maternal diabetes problems, especially during the first few weeks when a woman may be unaware she is pregnant. For this reason, women with diabetes are advised to manage their insulin levels under control before attempting to conceive.