Could diabetes during pregnancy cause obese babies?

If you had diabetes when you were pregnant, you might be worried about the effect it had on your baby.  Experts have come up with many theories about why the obesity epidemic in developed nations has come on so quickly. Some factors are obvious. For many people (though clearly not all), food is available at more affordable prices. Portion sizes and less physical activity also contribute to the sudden rise in obesity. But which of these, if any, is the primary reason?

An article in the September issue of Diabetes Care adds another reasonable theory to the mix.

Teresa Hillier, M.D., and her colleagues from the Kaiser Permanente Medical Center in Portland, Oregon, conducted the study. They looked for links between blood sugar levels in women who develop diabetes during pregnancy and the risk of obesity in their young children. Higher average blood sugars during pregnancy strongly increased the risk of childhood obesity. This type of diabetes is called gestational diabetes.

There's good news in this study, too. A pregnant woman who works hard to keep her blood sugars normal can substantially reduce the obesity for her child. Women in the study did this with diet, exercise, and intensive insulin therapy, if needed.

Better blood sugar control also makes it easier for the mother to deliver the baby. Lower blood sugars prevent the fetus from growing too large in the womb.

Keeping blood sugar normal during pregnancy

To help keep blood sugar from getting too high, forget the saying that pregnant women should "eat for two." Women who have a normal body weight at the start of pregnancy should consume 300 extra calories per day. But for overweight and obese women, this is probably too much. Underweight women should eat more.

The amount of weight gain during pregnancy depends on your weight before you got pregnant. The Institute of Medicine and American College of Obstetricians and Gynecologists recommend these goals:

·         For underweight women — Gain 28 to 40 pounds.

·         For women of average weight — Gain 25 to 35 pounds.

·         For overweight women — Gain 15 to 25 pounds.

·         For obese women — Gain about 15 pounds.

Ideally, weight gain during pregnancy should be gradual. Most of the gain should occur during the second half of pregnancy.

Women who have diabetes before pregnancy or develop diabetes during pregnancy will want to keep blood sugars as close to normal as possible. For pregnant women with diabetes, weight gain is a less important goal.

Women should not be pressured any more than men to maintain a healthy weight. But women considering pregnancy should keep in mind that their weight affects the health and obesity risk of their children. This will surely be an additional motivator for weight control.

Julie K. Silver, M.D., is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. She is also the Chief Editor of Books for Harvard Health Publications.

Diabetes

Nearly 21 million Americans suffer from diabetes, and as anyone who has been affected by the disorder knows, it is about much more than a statistic: it means a new way of life. Diabetes: A plan for livingis a special report from Harvard Medical School that will help you learn how to better understand and manage your diabetes, including type 1 and type 2, as well as other variations of the disease. This report will show you that it’s not just possible to live with diabetes; it’s possible to live well.

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