Pregnant individuals with gestational diabetes often consider delivery timing, especially around 37 weeks. This decision balances medical considerations for both parent and baby. Healthcare providers evaluate specific circumstances, as the approach to delivery timing is not uniform.
Understanding Gestational Diabetes and Delivery Timing
Gestational diabetes (GDM) is a condition where high blood sugar levels develop or are first identified during pregnancy. Uncontrolled blood sugar allows excess glucose to pass to the fetus, which responds by producing more insulin. This can lead to increased growth and fat deposition.
The 37-week mark is often considered for delivery in GDM pregnancies because it is full-term. Healthcare providers consider this timeframe to reduce risks if blood sugar control is a concern. This approach aims to mitigate complications that can arise closer to the estimated due date.
Considerations for Delivery at 37 Weeks
Delivering at 37 weeks with gestational diabetes presents benefits and risks. A significant benefit is the reduction of macrosomia, where the baby grows larger than average. Macrosomia increases the likelihood of complications like shoulder dystocia during vaginal birth, and may necessitate a cesarean section. Earlier delivery may also mitigate the risk of stillbirth in pregnancies with poorly controlled diabetes.
Despite these advantages, delivering at 37 weeks carries risks for the newborn. Babies of mothers with gestational diabetes have a higher chance of developing neonatal respiratory distress syndrome (RDS), even if born at term. This risk is linked to delayed lung maturation caused by the fetus’s higher insulin levels.
Neonatal hypoglycemia, or low blood sugar, is another common concern. Babies accustomed to high glucose levels in the womb may struggle to regulate their own blood sugar after birth, potentially leading to symptoms like tremors or lethargy. Inducing too early, especially with an unripe cervix, may increase the birthing parent’s risk of needing a cesarean section.
Factors Influencing the Decision
The decision to deliver at 37 weeks is an individualized choice made in consultation with a healthcare team.
A primary factor is the severity and control of gestational diabetes. Well-controlled diabetes might allow for delivery closer to 39 or 40 weeks, while poorly controlled cases may prompt earlier intervention.
Other pregnancy complications, such as preeclampsia or excessive amniotic fluid (polyhydramnios), also influence delivery timing. Fetal well-being monitoring, including non-stress tests, biophysical profiles, and ultrasound scans, provides essential information. The birthing parent’s overall health is also considered. Shared decision-making with the medical team ensures the safest plan for both parent and baby.
What to Expect During and After Delivery
When delivery at 37 weeks is planned due to gestational diabetes, labor induction is typically performed. This may involve medications to ripen the cervix, stimulate contractions, or artificial rupture of membranes. While vaginal birth is often the goal, a cesarean section might be recommended if the baby is very large or other complications arise.
After delivery, the birthing parent’s blood sugar levels are closely monitored, and diabetes medications are usually discontinued. A glucose screening test is commonly recommended between 6 and 12 weeks postpartum to assess for ongoing diabetes.
For the newborn, blood sugar levels are checked soon after birth, and early feeding is encouraged to help stabilize glucose. If the baby’s blood sugar remains low or other health concerns are present, a stay in the neonatal intensive care unit (NICU) may be necessary for closer monitoring and support.