A client with gestational diabetes asks the nurse about the risk of the baby growing larger than usual.

The nurse explains that this condition is known as macrosomia and it can result in which of the following difficulties during delivery?

The correct answer is choice D. Genetic factors.This is because having gestational diabetes increases the risk of developing type 2 diabetes later in life for both the mother and the baby, and this risk is influenced by genetic factors.

Some possible explanations for the other choices are:

• Choice A is wrong because the baby’s excessive insulin production is a result of high blood sugar levels in the mother, not a cause of gestational diabetes.

• Choice B is wrong because poor placental function is not a primary cause of gestational diabetes, although it may be affected by high blood sugar levels in the mother.

• Choice C is wrong because uncontrolled blood sugar levels during pregnancy are a consequence of gestational diabetes, not a primary cause of it.

The correct answer is

B. Need for induced labor or cesarean section.

Gestational diabetes mellitus (GDM) is a condition where the mother has high blood sugar levels during pregnancy.

This can affect the growth and development of the baby.

One of the possible complications of GDM is fetal macrosomia, which means the baby is larger than normal for its gestational age.Macrosomia is usually defined as a birth weight above 4000 to 4500 grams (or 9 to 10 pounds).

Macrosomia can cause difficulties during delivery, such as shoulder dystocia, which is when the baby’s shoulder gets stuck behind the mother’s pelvic bone.This can lead to injuries to the baby’s nerves, bones, or muscles, or to the mother’s vagina, uterus, or bladder.To prevent these complications, doctors may recommend inducing labor or performing a cesarean section (C-section) to deliver the baby safely.

The other statements are wrong because:

A. Increased risk of jaundice.

Jaundice is a condition where the baby’s skin and eyes turn yellow due to high levels of bilirubin in the blood.

Bilirubin is a waste product that is normally removed by the liver.Jaundice can occur in any newborn, but it is more common in babies with GDM because they may have polycythemia (too many red blood cells) or hypoglycemia (low blood sugar levels) that can affect the liver function.

However, jaundice is not directly related to macrosomia and does not cause difficulties during delivery.

•

C. Development of preeclampsia.

Preeclampsia is a serious condition where the mother develops high blood pressure and protein in the urine after 20 weeks of pregnancy.

Preeclampsia can cause complications such as seizures, stroke, organ damage, or placental abruption (when the placenta separates from the uterus before delivery).Preeclampsia can increase the risk of fetal growth restriction (when the baby does not grow well in the womb), not macrosomia.

Preeclampsia can also cause difficulties during delivery, but it is not a result of macrosomia.

D. Higher risk of stillbirth.

Stillbirth is when the baby dies in the womb after 20 weeks of pregnancy.

Stillbirth can occur due to various causes, such as infections, genetic abnormalities, placental problems, or umbilical cord accidents.Stillbirth can also occur in babies with GDM because they may have hypoxia (low oxygen levels) or acidosis (high acid levels) in the blood due to poor placental function or uncontrolled blood sugar levels.

However, stillbirth is not directly related to macrosomia and does not cause difficulties during delivery.