Angela Onwuzoo
Congenital malformations and perinatal morbidity remain common among children whose mothers had diabetes during pregnancy, underscoring the need for diabetic mothers to seek specialist care while pregnant, seasoned experts have said.
According to them, women with diabetes in pregnancy are at risk of progression of microvascular diabetic complications, as well as early pregnancy loss, pre-eclampsia, polyhydramnios and premature labour.
The experts said it was important for pregnant women to have good antenatal care to reduce the risk of pregnancy complications that could affect the eyes of their babies when born.
The Mayo Clinic defines gestational diabetes as diabetes that is diagnosed for the first time during pregnancy (gestation).
“Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby’s health,” the clinic stated.
PUNCH Healthwise recently reported that the World Health Organisation released its first global guidelines for the management of diabetes during pregnancy.
In the new recommendations, the global health body provided a roadmap to prevent serious complications from diabetes for both women and their children.
The guideline was launched to commemorate World Diabetes Day 2025, themed ‘Diabetes across life stages’.
According to the WHO, diabetes in pregnancy, if not managed effectively, significantly increases the risk of life-threatening conditions such as pre-eclampsia, stillbirth and birth injuries.
“It also has long-term consequences, elevating the lifetime risk of type 2 diabetes and cardiometabolic diseases for both mother and child.
“The burden is greatest in low- and middle-income countries, where access to specialised care and resources may be limited, yet the need is most acute,” the WHO said.
Experts warned that if gestational diabetes is not detected and treated early, it could lead to pregnancy complications, including stroke and kidney problems for mothers, while exposing babies to multiple complications, including cataracts.
Contrary to the belief that cataracts occur mainly in older adults, eye specialists say babies and children can be born with or develop the condition.
The ophthalmologists explained that pregnant women with uncontrolled diabetes and other metabolic diseases may give birth to babies with cataracts, although there are other causes of congenital cataracts in children.
They stressed the importance of quality antenatal care in reducing the risk of pregnancy complications that could affect the eyes of babies at birth.
According to them, cataracts in children may be present at birth (congenital) or acquired after birth, noting that eye injuries can also cause cataracts in children.
The WHO defines cataract as a clouding of the lens of the eye that affects vision, noting that it is the most common cause of blindness and visual impairment, often related to ageing.
A paediatric ophthalmologist, Dr Halima Alimi, said pregnant women with uncontrolled diabetes and other metabolic diseases may give birth to babies with cataracts, even though there are other causes of congenital cataracts in children.
“Part of the congenital causes of cataract includes infections during pregnancy, which we call intrauterine infections. Most of these infections are viral. There are several diseases that pregnant mothers may have that can lead to cataracts in babies.
“Also, children whose mothers have certain metabolic diseases, such as uncontrolled diabetes, may be born with metabolic disorders that can cause cataracts as well,” she said.
According to Sightsavers, an international non-governmental organisation working to treat and prevent avoidable blindness in developing countries, cataracts are among the leading causes of visual impairment and blindness in children.
A Professor of Medicine at the College of Medicine, Lagos State University, Ikeja, Prof. Anthonia Ogbera, noted that age plays a significant role in the development of gestational diabetes, in addition to factors such as family history of diabetes, hypertension and obesity.
Speaking with PUNCH Healthwise, the endocrinologist disclosed that many women in Nigeria are unaware of gestational diabetes and its associated risks.
She said women above the age of 24 who become pregnant are at increased risk of developing gestational diabetes.
Ogbera advised pregnant women to undergo diabetes screening during their first antenatal visit for early detection.
She warned that failure to detect gestational diabetes early could result in complications such as stroke and kidney problems.
The consultant physician added that gestational diabetes could cause serious pregnancy and delivery complications and increase the future risk of diabetes in both mother and child.
Ogbera said, “Four to 14 per cent of women in Nigeria have diabetes in pregnancy. Women at risk include those who are obese, those with a family history of diabetes, women living with hypertension, those who had diabetes in a previous pregnancy, and women who become pregnant after the age of 25.
“That is why we advise that women attending antenatal care for the first time should be screened for diabetes.”
She also urged pregnant women to adopt healthy lifestyles, particularly those with risk factors such as hypertension.
“Research has shown that with a healthy lifestyle, the risk of developing diabetes is lower. People should be physically active. Washing plates and cleaning the house do not translate to being physically active.
“Pregnant women should watch what they eat and consume more traditional foods. A healthy lifestyle is the way to go,” she said.
A 2021 study published on ScienceDirect titled ‘Knowledge of gestational diabetes mellitus among pregnant women in a semi-urban hospital – A cross-sectional study’ called for increased awareness of the effects of gestational diabetes on both mothers and newborns to improve screening, especially among non-graduates and rural dwellers.
The authors said grassroots health workers should be more involved in educating pregnant women in rural areas.
They noted, “Abnormal blood glucose levels in pregnant women can affect the immediate and long-term health of both mother and baby. Gestational diabetes affects two generations — the present and the next.
“It is associated with increased risks of maternal and neonatal complications such as pre-eclampsia, macrosomia, shoulder dystocia, birth injuries, increased risk of caesarean delivery, hypoglycaemia, neonatal jaundice, respiratory distress syndrome, polycythaemia and hypocalcaemia in newborns.
“Both gestational diabetic mothers and their offspring are at risk of developing type 2 diabetes and obesity in the future. There is a 50 per cent risk of gestational diabetic mothers developing overt diabetes within 20 years.”
They concluded, “Gestational diabetes screening provides a crucial opportunity to prevent diabetes in two generations. Knowledge among antenatal women will promote healthy lifestyles, improve healthcare-seeking behaviour and enable early diagnosis and prevention.”
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