About 4% of pregnant women will develop a diabetes-like condition during their pregnancy. Like diabetes mellitis, women with Gestational Diabetes Mellitis (GDM) will have high blood sugars. If not treated, many of these women will give birth to very large babies, a condition known as macrosomia. The baby with macrosomia weighs over 4500 grams, 10 pounds, at birth. A baby this big presents some obvious problems, since the pelvis is designed for something a bit smaller (although most ten-pound babies can fit through the average pelvis).
Diabetes Mellitis
Prior to the discovery of insulin (in 1922), the mortality rate of pregnant women with diabetes mellitis was 45%. It quicky dropped to 2% after the introduction of insulin. It became very clear that the pregnant woman with diabetes needed very special attention during her pregnancy. If you have insulin-dependent diabetes and are pregnant or planning to become pregnant, see your physician immediately…….the sooner; the better.
Fetal Fibronectin
You may start hearing more about a substance (and a test) called fetal fibronectin. Fibronectin is a protein that resides in the cells where the fetal membranes come in contact with the uterus. The fetal membranes are also known as the “bag of waters”, or amniotic sac. No one is certain what role fibronectin plays in the fetal membranes. It appears that it may be some sort of biological glue. In any case, fibronectin is there near the membranes (there are 2 membranes, the amnion and the chorion), and in most pregnancies stays put until labor begins.
Preterm Labor and Birth
9% of babies are born between the “age of viability” (about 26 weeks) and 37 weeks. These babies are born prematurely; before they are completely mature enough to function fully outside the mother.
Drug Abuse
If you use any street drugs, try to stop immediately. If you can’t stop, talk to your health care clinician and get some help. Although the evidence is somewhat unclear, almost all street drugs have been shown to negatively affect your pregnancy and your family’s health. The use of street drugs is usually evidence of depression, poor coping skills, and/or low self esteem………all factors which make pregnancy and raising a family more difficult.
Alcohol
Alcohol (ethyl alcohol or ethanol) is clearly a teratogen. Fetal Alcohol Syndrome (FAS) is caused by drinking alcohol during pregnancy. Fetal Alcohol Syndrome (FAS) is a group of related birth defects including some facial abnormalities, growth retardation, and varying levels of mental retardation. The problem is dose-related. That is, the more one drinks, the greater the chance of FAS (or some aspects of it). However, several aspects of the problem are still quite unclear.
Cigarettes
Cigarettes are on the short list of possible teratogens. Cigarette smoking is also a risk factor for premature labor and fetal growth retardation. If you smoke cigarettes, try to stop. If you are not able to stop, at least try to cut down on the numbers of cigarettes you smoke AND the number of “drags” you take off any one cigarette.