A pregnancy can be classified as high risk if the pregnant mother has a condition that poses a threat to her and/or her baby. Pregnant mothers can have many pre-existing conditions, such as high blood pressure, diabetes or epilepsy, and disorders that unexpectedly present during pregnancy, such as an infection, preeclampsia or Rh incompatibility that can lead to hemolytic disease of the fetus and newborn (HDFN).
What is HDFN?
Hemolytic disease of the fetus and newborn (HDFN) is an immune-mediated red blood cell (RBC) disorder that occurs when a baby’s RBCs break down quickly, which is called hemolysis. HDFN is caused by a mismatch between a mother’s and her baby’s blood type (A, B, AB, or O) or Rhesus (Rh) factor (Rh-positive or Rh-negative) during pregnancy. Numerous antibodies to RBC antigens can be linked to HDFN, such as those from the ABO and Rh blood group systems.
Some conditions are more serious than others, but the risk for mother and baby escalates when two or more health conditions need to be managed simultaneously during pregnancy.
Pregnancy and diabetes
Diabetes is a common cause of pregnancy and birth complications, either as a pre-existing condition or due to onset during pregnancy (gestational diabetes). High blood glucose levels in the pregnant mother can have a negative impact on their developing baby. High glucose levels also increase the risk of miscarriage, stillbirth, premature delivery, high birth weight, birth defects and difficulty breathing.
Maintaining normal blood glucose levels before and during pregnancy contribute to positive outcomes for mother and baby. Staying healthy via effective blood glucose control is possible with the support of a dedicated healthcare team, a diabetes meal plan, a healthy active lifestyle and taking the prescribed medication.
Managing diabetes in pregnancy can become more complicated if another condition is identified during pregnancy, such as HDFN, a blood disorder that occurs in the fetus when the mother and baby have incompatible blood types.
Pregnancy and diabetes with HDFN
The potential risk of HDFN is usually unexpected and only identified during prenatal screening. Once identified, the pregnant mother is referred to a specialized fetal medicine center to ensure close monitoring and timely diagnosis and intervention if HDFN develops and her baby needs urgent care.
Learn more about HDFN testing and diagnosis
If a pregnant mother who suffers from diabetes is also at risk of HDFN, she will require extra medical care and support as she navigates the challenges of a high-risk pregnancy. The combination of diabetes and HDFN could potentially have negative consequences for mother and baby. For example, the additional and unplanned stress of managing an HDFN-affected pregnancy could have a major effect on her blood glucose levels, making them difficult to control.
The effect on the pregnant mother’s well-being can also be negative, with depression often occurring more often in people with diabetes. The risk of complications during pregnancy and birth are therefore greater.
Specialized care during high-risk pregnancies
There are numerous risk factors for pregnant women, and once the risk is heightened, the proper care needs to be identified. High-risk pregnancies require specialized care and close monitoring throughout pregnancy and delivery. Maternal-fetal medicine specialists are obstetricians with expertise in caring for women with high-risk pregnancies. The physical and emotional health of the mother need to be prioritized to ensure positive outcomes for mother and baby.
