five women who has gestational diabetes will
develop conventional diabetes within five years of
her baby’s birth, and about two thirds of women
will develop the condition later in life.
Risk Factors and Preventive MeasuresAny pregnant woman can develop gestational dia-
betes. Factors that increase the risk for gestational
diabetes include
- gestational diabetes in a previous pregnancy
- obesity
- African American or Hispanic heritage
- age 25 or older
Because gestational diabetes results from the
effects in the woman’s body of hormones the pla-
centa produces, there are no certain measures to
prevent its development. Lifestyle measures to
maintain nutritious eating habits, daily exercise,
and healthy weight help the body use glucose and
insulin as efficiently as possible.
See also ECLAMPSIA; LIFESTYLE AND HEALTH;
PREECLAMPSIA; WEIGHT LOSS AND WEIGHT MANAGEMENT.
gestational hypertension See PREECLAMPSIA.
gestational surrogacy A circumstance in which
one woman carries a PREGNANCY for another
woman who cannot carry it herself. Gestational
surrogacy is among the possible solutions for
INFERTILITY, typically in circumstances such as uter-
ine malformation that prevent successful implan-
tation or carrying the pregnancy to term.
The woman who carries the pregnancy is the
gestational surrogate or gestational carrier; the
woman to whom the pregnancy belongs is the
intended parent. The gestational surrogate may be
a relative of or a woman or couple desiring the
pregnancy, may know the woman or couple desir-
ing the pregnancy, or may make herself available
to a FERTILITYclinic for the purpose of gestational
surrogacy. The pregnancy takes place through
some form of ASSISTED REPRODUCTIVE TECHNOLOGY
(ART), typically in vitro fertilization. ART may use
the intended mother’s egg, a donor egg, or the
gestational surrogate’s egg fertilized with the
intended father’s SPERMor donor sperm. As with
any pregnancy, multiple factors affect the success
of these efforts.
Gestational surrogacy entails intense emotional
and legal complexities as well as physical and
health risks for the gestational surrogate. Women
considering gestational surrogacy, whether as
intended parent or gestational surrogate, should
obtain legal advice before initiating the process. It
is crucial for all participants to fully understand
the risks and to agree, via written contract, to the
conditions of the arrangements. In the United
States each state determines the legal status of
surrogacy; many states restrict financial arrange-
ments with and payments to gestational surro-
gates as well as tightly regulate the myriad aspects
of legal parentage and responsibility. Though ges-
tational surrogacy is often a positive experience
for all involved, the potential for complications
and problems exists.
See also ADOPTION; FAMILY PLANNING.gynecomastia BREAST enlargement in a man.
Gynecomastia may be a symptom of OBESITYor
hormonal imbalance such as may occur during
PUBERTYor with various endocrine disorders that
affect the production of TESTOSTERONE. Advanced
CIRRHOSIS, LIVER CANCER, and chronic ALCOHOLISM
often produce gynecomastia because the resulting
dysfunction of the LIVERalters how the adipose
(fat) cells metabolize ESTROGENS. Estrogen levels in
the BLOODcirculation tend to rise with chronic
liver disease or damage to the liver. Gynecomastia
is also a characteristic SIDE EFFECTof HORMONE THER-
APYto treat PROSTATE CANCER, again because the bal-
ance of estrogen in the blood circulation increases.
Treatment for gynecomastia depends on the
underlying cause.
See also MASTALGIA.gynecomastia 289