A nurse is conducting a prenatal class for women who have gestational diabetes.

The nurse should inform the women that having gestational diabetes increases their risk of having which of the following complications during pregnancy?

The correct answer is choice B. The woman delivered a baby who weighed 3 kg (6.6 lb) at birth.

This indicates that the interventions were successful because the baby’s weight is within the normal range and not affected by gestational diabetes mellitus (GDM).According to one study, an ideal gestational weight gain (GWG) range for women with GDM is 8-11.9 kg for normal weight, 6-7.9 kg for overweight, and -5-3.9 kg for obesity.

Choice A is wrong because the woman gained less than 10 kg (22 lb) during pregnancy.This may be too low for a normal weight woman and may increase the risk of small for gestational age (SGA) or preterm birth.

Choice C is wrong because the woman had no episodes of hypoglycemia or hyperglycemia during pregnancy.

This may be a result of good blood glucose control, but it does not reflect the outcome of the interventions on the baby’s health.

Choice D is wrong because the woman’s blood glucose levels returned to normal within six weeks after delivery.This may happen in most women with GDM, but it does not indicate the effectiveness of the interventions during pregnancy.

The correct answer is choiceD.

No history of endocrine disorders.This factor increases the client’s risk of developing gestational diabetes because endocrine disorders such as thyroid disease or polycystic ovary syndrome can affect insulin resistance and glucose metabolism.

Choice A is wrong because having a previous baby withlow birth weightis not a risk factor for gestational diabetes.In fact, having a previous baby withhigh birth weight(> 9 pounds) is a risk factor.

Choice B is wrong because being ofCaucasian originis not a risk factor for gestational diabetes.In fact, being ofnon-Caucasian originsuch as African American, Hispanic, Native American, Asian American, or Pacific Islander is a risk factor.

Choice C is wrong because havingno family history of diabetesis not a risk factor for gestational diabetes.In fact, having afamily history of diabetes(especially type 2 diabetes) in a first-degree relative (parent or sibling) is a risk factor.

Some other risk factors for gestational diabetes include being older than 25 years, being overweight or obese, having prediabetes or impaired glucose tolerance, having a history of gestational diabetes in a previous pregnancy, having hypertension or preeclampsia, or having polycystic ovary syndrome.

Normal ranges for fasting plasma glucose are 60 to 99 mg/dL for nonpregnant women and 70 to 95 mg/dL for pregnant women.Normal ranges for oral glucose tolerance test are less than 140 mg/dL at 1 hour and less than 120 mg/dL at 2 hours for nonpregnant women and less than 180 mg/dL at 1 hour and less than 155 mg/dL at 2 hours for pregnant women.