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Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. [2] Gestational diabetes generally results in few symptoms; [2] however, obesity increases the rate of pre-eclampsia, cesarean sections, and embryo macrosomia, as well as gestational diabetes. [2]
Pre-gestational diabetes can be classified as Type 1 or Type 2 depending on the physiological mechanism. Type 1 diabetes mellitus is an autoimmune disorder leading to destruction of insulin-producing cell in the pancreas; type 2 diabetes mellitus is associated with obesity and results from a combination of insulin resistance and insufficient insulin production.
Pregnant women fall at a similar rate (27%) to women over age of 70 years (28%). Most of the falls (64%) occur during the second trimester. Additionally, two-thirds of falls are associated with walking on slippery floors, rushing, or carrying an object. [38] The root causes for these falls are not well known.
During pregnancy, a woman's mass increases by about 12 kg (26 lb). [39] The European Food Safety Authority recommends an increase of 300 mL per day compared to the normal intake for non-pregnant women, taking the total adequate water intake (from food and fluids) to 2,300 mL, or approximately 1,850 mL/ day from fluids alone. [40]
There are several non-modifiable and modifiable risk factors that predispose women to development of this condition such as female fetus, psychiatric illness history, high or low BMI pre-pregnancy, young age, African American or Asian ethnicity, type I diabetes, multiple pregnancies, and history of pregnancy affected by hyperemesis gravidarum.
Gestational diabetes is a form of diabetes that is first diagnosed during pregnancy and can accordingly cause high blood sugar that affects the woman and the baby. [9] In 10 - 20% of women whose diet and exercise are not adequate enough to control blood sugar, insulin injections may be required to lower blood sugar levels. [ 9 ]
A high-risk pregnancy is a pregnancy where the mother or the fetus has an increased risk of adverse outcomes compared to uncomplicated pregnancies. No concrete guidelines currently exist for distinguishing “high-risk” pregnancies from “low-risk” pregnancies; however, there are certain studied conditions that have been shown to put the mother or fetus at a higher risk of poor outcomes. [1]
Both circulating and placental levels of soluble fms-like tyrosine kinase-1 (sFlt-1) are higher in women with pre-eclampsia than in women with normal pregnancy. [26] sFlt-1 is an anti-angiogenic protein that antagonizes vascular endothelial growth factor (VEGF) and placental growth factor (PIGF), both of which are proangiogenic factors. [15]
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