GD & Small Baby – Who to Ask for Answers?

[MN7]

Hi everyone, I had gestational diabetes during my last pregnancy, but all my scans were normal. However, when my baby was born, she was unexpectedly small. The hospital took my placenta for testing, but when I asked about it, they just told me to go home and enjoy my baby. Now that we’re planning another pregnancy, I’d really like to understand what happened and whether I need to take any precautions this time. I don’t have any related information on my NHS app, so I’m not sure who to contact for answers. Has anyone been in a similar situation or know what I should do next?

I would see if your hospital offers a debrief service for someone to review your notes with you, the lab report regarding your placenta will be part of your notes. Failing that, you are entitled to request your birth notes. But you'd need someone with some understanding of the lab reports to review it with you. If you do get a debrief and anything has been identified on the placental histology that requires action for another pregnancy, the person doing the debrief should be able to refer you to a consultant.

I haven't had a further pregnancy after my SGA/FGR last, but I recommend searching out Facebook groups (search "IUGR" or SGA) for helpful advice/ others' experiences. I understand you should be on aspirin and have extra monitoring in any subsequent pregnancies. Your GP should have the receipt of any pathology reports re the placenta so they might be a good place to start. All the best 🙂

The baby only really gets big with GD if your sugars are high. If they caught you early and controlled it well then that may just be the size she was meant to be.

A debrief should be available though if you want one.

How small was she? Could she just have naturally have been small?

My baby was 6lb even and born at 41 weeks. No issues during the pregnancy at all.

I've had GD twice. My 2nd ended up slightly smaller but neither were big babies. Very average in fact.

In terms of difference in pregnancy care, I got tested even earlier than the first time round (16wks vs 28 weeks) but otherwise nothing different.

How small was he and at what gestation? Gd babies can get big if the diabetes isn't under control. I had GD (no risk factors) so was at risk of having a big baby. I also had a hormone problem which put me at risk of having a small baby. In the end he was 6lb 2 so quite small (first was 7lb 9).
He did seem to stop growing towards the end of pregnancy and I was induced because of it. They weren't sure why.
Can you look on your notes or ask your midwife if she can find out any more information for you?

Exactly the same for me but my second baby was bigger and I ate no sugar so I was a smaller pregnant person.

I had bi weekly scans and prenatal endo appointments. Felt like I was always being tested for something….

I will have to check with that, its been three years. I am not pregnant yet just trying to conceive.

Aspirin? For what?
also nobody told me that she was IUGR baby. They said some babies are just small. She was 5lbs3oz. She still is petite.

Do I need to ask my GP for this debrief?

Do I need to contact GP for debrief?

I had GD first time round and SGA baby. GD was well controlled but baby was just small (I'm not huge myself!). Pregnant with DC2 and no diabetes so far (35 weeks) this baby is actually measuring very long (average weight however). You aren't guaranteed GD the second time round and every pregnancy is different for no real reason. There was absolutely no difference between my life style in first and second pregnancy so it's just by chance I haven't ended up with it again - it's been absolutely nothing I've done. They are very cautious (or at least my trust is) with any off normal previous pregnancy or measurements in your current one and will quickly sign you up for growth scans so don't let the worry put you off!

Aspirin? For what?
also nobody told me that she was IUGR baby. They said some babies are just small. She was 5lbs3oz. She still is petite.

You are so lucky to not have it this time. I am hoping that too. My last pregnancy was horrible. Do you think there is anything you did that saved you from having GD this time?

She was 5lbs3oz so small and born on her due date. I am not tall too so may be genetics. But I was fine as a baby. She has always been petite.
My hospital didn’t give me any notes, the midwife’s one they kept with them. I am not pregnant just trying so I don’t have a midwife yet to ask.

What gestational was she born? 5lbs 3oz wont necessarily be IUGR - DD1 was 5lb 12oz at 38w and classed as Small for Gestational Age. I didnt have to do anything different in my second pregnancy. Pp are mentioning asprin because now many women are advised that taking low dose asprin daily between 12-36w promotes better blood flow through the cord and placenta which can support better growth in babies - it also helps to prevent preeclampsia, which can cause growth issues in babies. But if you would need to do this, your MW would mention it at the booking appt.

Sorry, x-post with your update. Google birth debrief plus your hospital name and there will be a general email address. You can just email and ask about your previous pregnancy - they will get in touch and you'll be able to go from there.

She was 5lbs3oz born on due date. They were surprised because she had always been measuring around 25 centile on growth scans but was born below 10th centile.

Contact hospital directly. They often call it Birth Reflections or something similar. A dedicated midwife usually runs the service. It doesn't matter how long it's been, and oftentimes women only avail of the service when planning another pregnancy as they realise they have unanswered questions.

Aspirin is recommended where there were placental issues in a previous pregnancy. It aids placental function and blood flow so the idea is to prevent any blood flow issues again. Some babies are just genetically smaller so hopefully something like a debrief will give you a bit more clarity.

She may well not be IUGR - you can be SGA without being IUGR - like you say just hereditarily more petite. Mine was growth restricted - the growth velocity dropped dropped hugely in the last few weeks picked up in scans, and in an asymmetric fashion. No known cause in the end so I similarly have concerns should I try get pregnant again. I only mentioned IUGR as a search term as there's a UK facebook group for people that had SGA/IUGR babies that you may find helpful.

(I see others have already responded to the aspirin part..!)

Thanks for your reply. Really helpful. I will get on it and call hospital. Thanks.

Thanks I will definitely look for this group on fb. My girls had same growth through out scans at 25 percentile. Except for one where they said her belly was measuring a bit small. But they did another scan and weren’t bothered much. Nobody ever mentioned IUGR or SGA.
I hope everything goes well this time. Did your baby catch up after birth?

I was induced on my due date so she came one day after due date.
5lb 12oz is good weight, I wonder why they said she is SGA.So your second pregnancy baby weight was fine?
and yes about aspirin I will discuss with my midwife once I get pregnant. Thanks for your reply.

Thats very helpful, Thanks alot. Will do it. Atleast I know where to start now.

This is a long time ago now (both babies now teenagers) but I had a similar situation. GD in both pregnancies, but I managed to maintain tight control of my blood sugars. DS1 was born after spontaneous labour at 37 + 2 weighing 4lbs6oz. Placenta was tiny but for some reason was not analysed, much to the frustration of doctors in my second pregnancy. As the cause of DS1s low birth weight was unknown, they did fortnightly growth scans after 28 weeks. I was induced at 38 weeks with DS2 as the scans seemed to suggest his growth was slow, but he was a very healthy and normal 6lbs2oz.