Pregnant women who are even marginally overweight or with high blood sugar levels could face risks not only for themselves, but for their unborn babies.
Northwestern University’s Dr. Boyd Metzger talks about the effect of a mother’s blood sugar levels on pregnancy and what women can do to help prevent problems.
Metzger’s research has showed that women with slightly high levels of blood sugar could raise blood sugar levels in unborn babies. And the latest review of the data suggests that elevated blood sugar levels, as well as too much weight gain, can lead to riskier pregnancies.
Obstetricians routinely monitor a mother-to-be’s weight and blood sugar during pregnancy. Women may develop gestational diabetes, which is any form of glucose intolerance or high blood sugar that begins during pregnancy. The American Diabetes Association estimates that 18 percent of pregnant women develop this condition.
Metzger is a professor of metabolism and nutrition in the Division of Endocrinology, Metabolism & Molecular Medicine at Northwestern University’s Feinberg School of Medicine. He was the lead researcher of a large-scale international study focusing on weight gain and blood sugar levels during pregnancy.
What are your areas of interest and expertise?
I am interested in gestational diabetes. I also study the impact of a mother’s nutrition on the development of the fetus.
As the lead investigator in the Hyperglycemia and Adverse Pregnancy Outcome study, can you explain a little bit about what you researched and how you did it?
There has been a debate about how much high blood sugar contributes to an increased risk in adverse pregnancy situations. The purpose of the study was to determine where and how blood sugar levels, regardless of other factors, can affect a fetus. Some women develop what is called gestational diabetes during their pregnancy. Moms who have gestational diabetes usually share some common traits. They are often older, heavier, and have higher blood pressure. Our study followed women internationally, which meant we had a variety of participants and can see a wide application of results.
Did the study show that a mom’s blood sugar levels affect her unborn baby’s?
Across the whole series of people, the findings related to a mom’s blood sugar were pretty much linear. A lot of things in the medical world have a relationship that is continuous like this. Women with high blood sugar levels should be monitored, though there is no way to say when to intervene. For example, we have a number for blood pressure, 140/90, that has been determined to show whether or not someone has high blood pressure. We can’t say the same for gestational diabetes risks.
What kind of effects can a high blood sugar level cause?
It was clear that blood sugar levels and weight can contribute to an adverse outcome, like obesity or diabetes in the child. Subsequent to the study results being published, a whole series of papers were written. An international group reviewed the data and set diagnostic criteria for determining risks. The American Diabetes Association adopted them, but the American Congress of Obstetricians and Gynecologists has not.
That being said, how important is it for women to have dietary consultations during pregnancy?
I think it’s certainly something that is important. Given that the associations of overweight people who develop gestational diabetes are so large, everyone would benefit from consultation. Further, it would be beneficial for women to have consultation not only during pregnancy, but also prior to getting pregnant.
Does insurance cover diet services during pregnancy?
There is no standard requirement for services covered by insurance companies. Typically, whatever is covered is negotiated between the employer, employee, and insurance company. There are some things that are mandated, though. Things like mammogram screenings, preventative health procedures, and those kinds of things are generally covered. There is also sometimes coverage provided for diabetes in general, for things like glucose measuring tools. There is a suggested congressional mandate that would require tests to detect gestational diabetes. But as it is right now, there is no set of requirements for services that must be covered.