Relationship Between Maternal Glucose Levels and Congenital Malformations in the Infant of the Diabetic Mother

  • L. Jovanovic-Peterson
  • C. M. Peterson
Conference paper
Part of the Bayer AG Centenary Symposium book series (BAYER)

Abstract

Although there has been considerable improvement in the outcome of pregnancies complicated by diabetes [1–3], the incidence of congenital malformations in infants of diabetic mothers is still three times greater than the rate in the offspring of nondiabetic mothers [4–6]. Because the other problems associated with diabetic pregnancies, such as macrosomia, stillbirths, and intrauterine growth retardation, have been dramatically reduced, malformations have emerged as the most common cause of perinatal death among infants of diabetic women [7].

Keywords

Hyperglycemia Hypoglycemia Toxicology Alloxan Holoprosencephaly 

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References

  1. 1.
    Jovanovic L, Druzin M, Peterson CM (1981) The effect of euglycemia on the outcome of pregnancy in insulin dependent diabetes as compared to normal controls. Am J Med 71: 921–927PubMedCrossRefGoogle Scholar
  2. 2.
    Adashi EY, Pinto H, Tyson JE (1979) Impact of maternal euglycemia on fetal outcome in diabetic pregnancy. Am J Obstet Gynecol 133: 268–274PubMedGoogle Scholar
  3. 3.
    Peacock I, Hunter JC, Walford S, Allison SP, Symonds EM, Tattersall RB (1979) Self–monitor¬ing of blood glucose in diabetic pregnancy. Br Med J 1333–1336Google Scholar
  4. 4.
    Duncan JM (1982) On puerperal diabetes. Trans Obstet Soc London 24: 256–285Google Scholar
  5. 5.
    Molsted-Pedersen L, Tygstrup I, Pedersen J (1966) Congenital malformations in newborn infants of diabetic women. Correlation with maternal diabetic vascular complications. Lancet I: 1124–1162Google Scholar
  6. 6.
    Pedersen J (1977) The pregnant diabetic and her newborn, 2nd edn. Copenhagen, Munksgaard, pp 1–280Google Scholar
  7. 7.
    Mills JL (1982) Malformations in infants of diabetic mothers. Teratology 25: 385–394PubMedCrossRefGoogle Scholar
  8. 8.
    Eriksson UJ, Lewis NJ, Freinkel N (1984) Growth retardation during early organogenesis in embryos of experimentally diabetic rats. Diabetes 33: 281–284PubMedCrossRefGoogle Scholar
  9. 9.
    Endo A (1966) Teratogenesis in diabetic mice treated with alloxan prior to conception. Arch Environ Health 12: 492–500PubMedGoogle Scholar
  10. 10.
    Horii K, Watanabe G, Ingalls TH (1966) Experimental diabetes in pregnant mice: prevention of congenital malformations in offspring by insulin. Diabetes 15: 194–204PubMedGoogle Scholar
  11. 11.
    Brownscheidle CM, Davies DL (1981) Diabetes in pregnancy: a preliminary study of the pan-creas, placenta and malformations in the BB Wistar rat. Placenta 33 (Suppl): 203–216Google Scholar
  12. 12.
    Deuchar EM (1977) Embryonic malformations in rats, resulting from maternal diabetes: preliminary observations. J Embryol Exp Morphol 41: 93–99PubMedGoogle Scholar
  13. 13.
    Day R, Insley J (1976) Maternal diabetes and congenital malformations. Arch Dis Child 51: 935PubMedCrossRefGoogle Scholar
  14. 14.
    Bennett PH, Webner C, Miller M (1979) Congenital anomalies and the diabetic and pre-diabetic pregnancy. Ciba Found Symp 63: 207Google Scholar
  15. 15.
    Marble A, Krall LP, Bradley RF et al. (eds) (1985) Joslin’s diabetes mellitus, 12th edn. Lea and Febiger, Philadelphia, pp 701–702Google Scholar
  16. 16.
    Kucera J (1971) Rate and type of congenital anomalies among offspring of diabetic women. J Reprod Med 7: 61Google Scholar
  17. 17.
    Pedersen J (1977) The pregnant diabetic and her newborn. Copenhagen, Munksgaard, p 194Google Scholar
  18. 18.
    Mills JL, Baker L, Goldman AS (1979) Malformations in infants of diabetic mothers occur before the seventh gestational week: implications for treatment. Diabetes 28: 292–293PubMedCrossRefGoogle Scholar
  19. 19.
    Mills JL (1982) Malformations in infants of diabetic mothers. Teratology 24: 385CrossRefGoogle Scholar
  20. 20.
    Mills JL (1987) Congenital malformations in diabetes. Report of the 93rd Ross conference on pediatric research, pp 12–19Google Scholar
  21. 21.
    Hoet JJ (1986) The etiology of congenital malformations in the infants of the diabetic mother. In: Jovanovic L, Peterson CM (eds). Diabetes in pregnancy: teratology, toxicology and treatment. Praeger, Philadelphia, pp 72–82Google Scholar
  22. 22.
    Miller EM, Hare JW, Cloherty JR et al. (1981) Major congenital anomalies and elevated hemoglobin A1c in early weeks of diabetic pregnancy. N Engl J Med 304: 1331PubMedCrossRefGoogle Scholar
  23. 23.
    Ylinen K, Aula P, Stenman U-H et al. (1984) Risk of minor and major fetal malformations in diabetics with high haemoglobin Alc values in early pregnancy. Br Med J 289: 345CrossRefGoogle Scholar
  24. 24.
    Reid M, Hadden D, Harley JMG, et al. (1984) Fetal malformations in diabetics with high haemoglobin A1c in early pregnancy, letter. Br Med J 289: 1001CrossRefGoogle Scholar
  25. 25.
    Goldman J A, Dicker D, Feldberg D, Yeshaya A, Samuel N, Karp M (1986) Pregnancy outcome in patients with insulin-dependent diabetes mellitus with preconceptional diabetic control: a comparative study. Am J Obstet Gynecol 155: 293–297PubMedGoogle Scholar
  26. 26.
    Steel JM (1985) Prepregnancy counseling and contraception in the insulin-dependent diabetic patient. Clin Obstet Gynecol 28: 553–566PubMedCrossRefGoogle Scholar
  27. 27.
    Fuhrmann K, Reiher H, Semmler K et al. (1983) Prevention of congenital malformations in infants of insulin-dependent diabetic mothers. Diabetes Care 6: 219PubMedCrossRefGoogle Scholar
  28. 28.
    Fuhrmann K, Reiher H, Semmler K et al. (1984) The effect of intensified conventional insulin therapy before and during pregnancy on the malformation rate in offspring of diabetic mothers. Exp Clin Endocrinol 83: 173PubMedCrossRefGoogle Scholar
  29. 29.
    Mills JL, Fishl AR, Knopp RH et al. (1983) Malformations in infants of diabetic mothers: problems in study design. Prev Med 12: 274–286PubMedCrossRefGoogle Scholar
  30. 30.
    Mils JL, Knopp RH, Simpson JL, Jovanovic–Peterson L et al. (1988) Lack of relation of increased malformation rates in infants of diabetic mothers to glycemic control during organogenesis. N Engl J Med 318: 671–667CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • L. Jovanovic-Peterson
  • C. M. Peterson

There are no affiliations available

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