The impact of gestational diabetes on the fetus mainly manifests in early stages as spontaneous miscarriage, fetal malformations, and abnormal fetal development. As the fetus grows, the high maternal blood sugar levels can lead to a large fetus, which increases the risk of birth injuries during delivery. Due to the high insulin levels in the mother, the fetus may have hyperinsulinemia, which can cause recurrent hypoglycemia at birth. Additionally, the development and maturation of the fetal lungs are delayed, making the newborn more susceptible to respiratory distress syndrome. Furthermore, gestational diabetes also increases the risk of preterm birth.