A nurse in the perinatal clinic explains to a student nurse that which of the following patients are at highest risk of developing gestational diabetes? (Select all that apply.)
A.
A17-year-old in her second pregnancy
B.
A 24-year-old pregnant woman with placenta previa
C.
A 32-year-old woman with a BMI of 40
D.
A woman whose first baby weighed 10.5 lb (4.7 kg)
E.
A woman whose mother and sister had gestational diabetes
ANS: C, D, E
The risk factors for developing gestational diabetes include age older than 25; obesity; insulin resistance; polycystic ovary syndrome; history of pregnancy-related diabetes mellitus; history of a large-for-gestational age infant; hydramnios, stillbirth, miscarriage, or an infant with congenital anomalies during a previous pregnancy; family history of type 2 diabetes (first-degree relative); and ethnicity. Being young does not confer additional risk, nor does placenta previa. The 32-year-old is obese, the 10.5-lb baby is large for gestational age, and the mother and sister are first-degree relatives.
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