Stillbirth and Gestational Diabetes: How to Lower Your Risk

Stillbirth, or the loss of a pregnancy at 20 weeks of gestation or after, is a rare complication of gestational diabetes (GD). Gestational diabetes is when blood sugar levels rise during pregnancy in a person who did not have diabetes before pregnancy.

When stillbirth occurs in a person with gestational diabetes, it is typically in cases where GD was not diagnosed during pregnancy and thus was not able to be monitored or managed. Reasons for stillbirth are not well understood, but a variety of factors may be involved.

This article reviews the signs of gestational diabetes, how it causes stillbirth, prevention, and coping with the loss of a baby.

Pregnant person looking at ultrasound images

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Signs of Gestational Diabetes

Gestational diabetes affects up to 10% of pregnancies in the United States each year. GD has few early signs or symptoms. You may be a little thirstier than you usually are or urinate more. Both of these symptoms are common in pregnancy, so you might not think these are due to another condition.

This is why every pregnant person gets screened for GD about halfway through pregnancy. The aim is to diagnose GD as early as possible so it can be monitored and managed.

How Diabetes Causes Stillbirth

The exact reason for the association between GD and stillbirth is not fully known, but there are a variety of factors involved that might be associated with it.

Baby Size

GD can cause macrosomia, a condition where the fetus is much larger than it’s typically supposed to be. It often happens because the excess sugar from the pregnant person’s blood causes the fetus’s pancreas to make more insulin, a hormone that regulates blood sugar.

Increased insulin causes more fat to grow in the developing fetus. This can cause complications that might lead to stillbirth.

Poor Circulation

Poor blood circulation can also lead to reduced growth of the fetus in the uterus, which can then lead to stillbirth. Good circulation is important for the fetus to get oxygen and nutrients. Without adequate circulation, the fetus cannot survive.

Effects on the Development of the Placenta

Gestational diabetes is associated with changes in the placenta, the temporary organ that allows nutrient, oxygen, and waste exchange between the pregnant person and the fetus. Placental insufficiency may result, with the fetus not getting adequate nutrients and oxygen. This can lead to stillbirth.

High Blood Pressure

GD can increase the pregnant person's risk for high blood pressure and preeclampsia (a condition of high blood pressure and high protein levels in the urine), both of which are risk factors for stillbirth.

If GD is uncontrolled or not monitored, signs of high blood pressure may be missed, leading to stillbirth.

Damaged Blood Vessels

If blood vessels are damaged because of poor circulation or high blood pressure, this can affect the growth and health of the fetus and possibly lead to a stillbirth.

Prevention

While it may not always be possible to prevent stillbirth in someone with GD, there are things that can be done to help reduce the risk.

If you’re diagnosed with GD, your maternity healthcare provider will want to see you more often for monitoring and checkups. They will do a nonstress test (an assessment of fetal heart rate and movement) and biophysical profile (a nonstress test with an ultrasound). They may also ask you to do kick counts to monitor your baby’s activity.

To help keep your GD under control, they will talk with you about how to monitor your blood sugar, the range in which your numbers should be, and ways to help manage your blood sugar. This might involve changes to your diet or activity level as well as medication like insulin.

If you start to notice your numbers going up or are having a harder time controlling your blood sugar, talk with your healthcare provider as soon as possible. It’s important to keep your sugars in the target range, for the health of both you and your baby. Needing some help or support is completely OK.

Coping With a Stillbirth

Stillbirth and infant death are some of the most stressful experiences a person can endure. People do not always know what to say or how to support parents in a late-pregnancy loss. There may be misconceptions about the intensity of the grief parents often feel.

It is important to feel what you need to feel, be gentle with yourself, and get the support you need.

The grieving process takes time and is rarely straightforward, and that's OK. Finding ways to feel and express your grief can help you in your process. This can include:

  • Journaling
  • Painting or drawing
  • Talking with a counselor
  • Joining a support group

Ask for help during this time, and allow others to help you. You've been through a lot emotionally and physically, and rest is important.

Help With Grief

Grief can be complex to navigate. It can help to speak with a mental health specialist, therapist, or grief counselor.

Honoring your baby is often part of the process of coping. This can take many forms, including naming them, planning their funeral or memorial service, or creating a memorial garden or space for them.

Summary

Gestational diabetes is associated with stillbirth and other pregnancy and birth complications. Though the exact reasons aren’t known, there are several possible associations, including the effect of high blood pressure, poor circulation, damaged blood vessels, high blood sugar, and the large size of the baby.

Because there may be no overt signs of gestational diabetes, every pregnant person is screened for it about halfway through pregnancy. This helps to diagnose GD as early as possible and allows healthcare providers to work with pregnant people to manage and monitor their blood sugar.

A Word From Verywell

Experiencing stillbirth is a stressful life event, no matter the reason. Grief does not follow a straight line. Take your time mourning, healing, and feeling everything you need.

Talk with your healthcare provider if you are having trouble doing everyday tasks, finding yourself isolated more and more, or feeling hopeless. Grief is normal and healthy, but depression that interferes with functioning may require professional assistance.

Frequently Asked Questions

  • Can high blood sugar cause stillbirth?

    Yes, it can. A 2019 study found that the pregnant person's blood sugar levels were a major risk factor for stillbirth. This is also a modifiable risk factor since blood sugar can be tracked and affected by things like diet, exercise, weight, and medication.

    Regular monitoring of blood sugar levels can help you be aware of how well your GD is being controlled and make any necessary changes to your diet or activity level. If you are on medication, it can also let your healthcare provider know whether the medication needs to be adjusted.

  • What are the signs of stillbirth?

    The most common symptom of a stillbirth is not feeling any movement from the fetus. There may also be cramping or vaginal bleeding. If you are experiencing these, call your healthcare provider for an appointment immediately.

    Once you are in the office, they will do an ultrasound to see if the fetus has a heartbeat. In a stillbirth, the heart will not be beating anymore.

 

 

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of gestational diabetes.

  3. Stanford Medicine. Diabetes during pregnancy.

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By Jaime R. Herndon, MS, MPH
Jaime Herndon is a freelance health/medical writer with over a decade of experience writing for the public.