GDM consequences in mothers and fetuses – the importance of monitoring thyroid function

Gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) are significant global health concerns, particularly affecting perinatal metabolism and endocrine functions. The management of these conditions varies, with a predominant two-step approach in the United States and an alternative 75-g, two-hour fasting oral glucose tolerance test advocated by the Diabetes in Pregnancy Study Group India (DIPSI). 

A recent prospective observational study conducted at Stanley Medical College Hospital in Chennai, India, from April 2020 to September 2021, aimed to assess the consequences of GDM in both mothers and fetuses. 

In this study, participants––first-trimester pregnant women without diabetes mellitus––underwent screening using the DIPSI technique. 

The results revealed harmful implications of GDM on both maternal and fetal health.Early detection and timely therapy were emphasized to mitigate short- and long-term consequences for both mothers and newborns. Birth weights ranging from 2.5 to 3.5 kg were comparable for GDM and IGT mothers, emphasizing the need for vigilance in monitoring both groups. Maternal hyperglycemia, even in milder forms of glucose intolerance, was linked to suppressed thyroid function in the developing fetus, potentially leading to altered fetal anthropometry and larger infants. 

Hence, the authors recommended assessing thyroid function in both mother and baby and providing postpartum blood sugar monitoring counseling upon discharge from the hospital. Overall, the research underscores the importance of comprehensive management strategies for GDM and IGT to improve outcomes for both mothers and infants.

Source: Vijayam B, Manoranjani K, Anandhi A, Shanmugam A, Balaji T, Balaji M S, Veerasamy S, Ganesan V K. Indian J ObstetGynecol Res. 2023;10(4):451-455