Which factor is known to increase the risk of gestational diabetes mellitus?

Choice A reason: Human immunodeficiency virus (HIV) is a viral sexually transmitted infection that causes acquired immunodeficiency syndrome (AIDS). It is characterized by a progressive decline of the immune system, leading to opportunistic infections and cancers. It does not have recurrent episodes, but rather a chronic and incurable course.

Choice B reason: Herpes simplex virus (HSV)-2 is a viral sexually transmitted infection that causes genital herpes. It is characterized by a primary infection followed by recurrent episodes of painful blisters and ulcers in the genital area. The virus remains latent in the nerve cells and can reactivate periodically or in response to triggers such as stress, illness, or menstruation.

Choice C reason: Human papillomavirus (HPV) is a viral sexually transmitted infection that causes genital warts and cervical cancer. It is characterized by a persistent infection that may or may not produce symptoms. It does not have recurrent episodes, but rather a variable and unpredictable course.

Choice D reason: Cytomegalovirus (CMV) is a viral sexually transmitted infection that causes mild or asymptomatic infections in healthy adults. It is characterized by a latent infection that can reactivate in immunocompromised individuals, causing serious complications such as retinitis, pneumonia, or encephalitis. It does not have recurrent episodes, but rather a dormant and opportunistic course.

Choice A reason: Maternal placenta previa is not a common complication of gestational diabetes mellitus. Placenta previa is a condition in which the placenta covers the cervix, which can cause bleeding and preterm labor. The risk factors for placenta previa include previous cesarean delivery, multiple pregnancy, advanced maternal age, and smoking.

Choice B reason: Maternal hyperemesis and neonatal low birth weight are not directly related to gestational diabetes mellitus. Hyperemesis is a severe form of nausea and vomiting during pregnancy that can cause dehydration and weight loss. The causes of hyperemesis are not well understood, but it may be influenced by hormonal changes, genetic factors, and psychological factors². Neonatal low birth weight is defined as a birth weight of less than 2,500 grams, which can be caused by many factors, such as prematurity, intrauterine growth restriction, maternal infection, and maternal malnutrition.

Choice C reason: Maternal premature rupture of membranes and neonatal sepsis are not specific to gestational diabetes mellitus. Premature rupture of membranes is a condition in which the amniotic sac breaks before labor begins, which can increase the risk of infection and preterm delivery. The causes of premature rupture of membranes are not clear, but some possible factors include infection, inflammation, stress, and trauma. Neonatal sepsis is a life-threatening infection in newborns, which can be caused by bacteria, viruses, or fungi. The risk factors for neonatal sepsis include prematurity, low birth weight, maternal infection, and invasive procedures⁵.

Choice D reason: Maternal preeclampsia and fetal macrosomia are the most common and serious complications of gestational diabetes mellitus. Preeclampsia is a condition characterized by high blood pressure and protein in the urine, which can lead to organ damage, seizures, and death. The exact cause of preeclampsia is unknown, but it may be related to abnormal placental development, immune system dysfunction, and genetic factors⁶. Fetal macrosomia is a condition in which the baby is larger than normal, usually weighing more than 4,000 grams at birth. This can cause difficulties during labor and delivery, such as shoulder dystocia, birth trauma, and cesarean section. The main cause of fetal macrosomia is excessive maternal glucose, which stimulates fetal insulin production and growth.