Gestational diabetes fetal complications: Difference between revisions
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*Fetal macrosomia results in increased metabolic demands that finally will cause increased mortality, metabolic acidosis, alterations in fetal iron distribution, increased erythropoiesis and resulting polycythemia.<ref name="pmid15157588">{{cite journal |vauthors=Nold JL, Georgieff MK |title=Infants of diabetic mothers |journal=Pediatr. Clin. North Am. |volume=51 |issue=3 |pages=619–37, viii |year=2004 |pmid=15157588 |doi=10.1016/j.pcl.2004.01.003 |url=}}</ref><ref name="pmid2199280">{{cite journal |vauthors=Widness JA, Teramo KA, Clemons GK, Voutilainen P, Stenman UH, McKinlay SM, Schwartz R |title=Direct relationship of antepartum glucose control and fetal erythropoietin in human type 1 (insulin-dependent) diabetic pregnancy |journal=Diabetologia |volume=33 |issue=6 |pages=378–83 |year=1990 |pmid=2199280 |doi= |url=}}</ref> | *Fetal macrosomia results in increased metabolic demands that finally will cause increased mortality, metabolic acidosis, alterations in fetal iron distribution, increased erythropoiesis and resulting polycythemia.<ref name="pmid15157588">{{cite journal |vauthors=Nold JL, Georgieff MK |title=Infants of diabetic mothers |journal=Pediatr. Clin. North Am. |volume=51 |issue=3 |pages=619–37, viii |year=2004 |pmid=15157588 |doi=10.1016/j.pcl.2004.01.003 |url=}}</ref><ref name="pmid2199280">{{cite journal |vauthors=Widness JA, Teramo KA, Clemons GK, Voutilainen P, Stenman UH, McKinlay SM, Schwartz R |title=Direct relationship of antepartum glucose control and fetal erythropoietin in human type 1 (insulin-dependent) diabetic pregnancy |journal=Diabetologia |volume=33 |issue=6 |pages=378–83 |year=1990 |pmid=2199280 |doi= |url=}}</ref> | ||
*Stillbirth is another complication of GDM which is because of increased catecholamine release, hypertension and increased cardiac workload.<ref name="pmid8299468">{{cite journal |vauthors=Kitzmiller JL |title=Sweet success with diabetes. The development of insulin therapy and glycemic control for pregnancy |journal=Diabetes Care |volume=16 Suppl 3 |issue= |pages=107–21 |year=1993 |pmid=8299468 |doi= |url=}}</ref> Hypertrophic cardiomyopathy due to increased oxidative stress is another cause of stillbirth in hyperglycemic mothers.<ref name="pmid25934526">{{cite journal |vauthors=Topcuoglu S, Karatekin G, Yavuz T, Arman D, Kaya A, Gursoy T, Ovalı F |title=The relationship between the oxidative stress and the cardiac hypertrophy in infants of diabetic mothers |journal=Diabetes Res. Clin. Pract. |volume=109 |issue=1 |pages=104–9 |year=2015 |pmid=25934526 |doi=10.1016/j.diabres.2015.04.022 |url=}}</ref> | *Stillbirth is another complication of GDM which is because of increased catecholamine release, hypertension and increased cardiac workload.<ref name="pmid8299468">{{cite journal |vauthors=Kitzmiller JL |title=Sweet success with diabetes. The development of insulin therapy and glycemic control for pregnancy |journal=Diabetes Care |volume=16 Suppl 3 |issue= |pages=107–21 |year=1993 |pmid=8299468 |doi= |url=}}</ref> Hypertrophic cardiomyopathy due to increased oxidative stress is another cause of stillbirth in hyperglycemic mothers.<ref name="pmid25934526">{{cite journal |vauthors=Topcuoglu S, Karatekin G, Yavuz T, Arman D, Kaya A, Gursoy T, Ovalı F |title=The relationship between the oxidative stress and the cardiac hypertrophy in infants of diabetic mothers |journal=Diabetes Res. Clin. Pract. |volume=109 |issue=1 |pages=104–9 |year=2015 |pmid=25934526 |doi=10.1016/j.diabres.2015.04.022 |url=}}</ref> | ||
==Neonatal complications== | |||
Insulin resistance, hyperinsulinemia and increased metabolic demands may result in neonatal co-morbidities including, | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Fetal complications
- Poor glycemic control during pregnancy may lead to some fetal disturbances. Congenital malformations are the most common complications seen in GDM compared to healthy mothers.[1]
- Maternal hyperglycemia will lead to hyperinsulinemia which secondarily will result in fetal macrosomia.
- Fetal macrosomia results in increased metabolic demands that finally will cause increased mortality, metabolic acidosis, alterations in fetal iron distribution, increased erythropoiesis and resulting polycythemia.[2][3]
- Stillbirth is another complication of GDM which is because of increased catecholamine release, hypertension and increased cardiac workload.[4] Hypertrophic cardiomyopathy due to increased oxidative stress is another cause of stillbirth in hyperglycemic mothers.[5]
Neonatal complications
Insulin resistance, hyperinsulinemia and increased metabolic demands may result in neonatal co-morbidities including,
References
- ↑ Mitanchez D, Burguet A, Simeoni U (2014). "Infants born to mothers with gestational diabetes mellitus: mild neonatal effects, a long-term threat to global health". J. Pediatr. 164 (3): 445–50. doi:10.1016/j.jpeds.2013.10.076. PMID 24331686.
- ↑ Nold JL, Georgieff MK (2004). "Infants of diabetic mothers". Pediatr. Clin. North Am. 51 (3): 619–37, viii. doi:10.1016/j.pcl.2004.01.003. PMID 15157588.
- ↑ Widness JA, Teramo KA, Clemons GK, Voutilainen P, Stenman UH, McKinlay SM, Schwartz R (1990). "Direct relationship of antepartum glucose control and fetal erythropoietin in human type 1 (insulin-dependent) diabetic pregnancy". Diabetologia. 33 (6): 378–83. PMID 2199280.
- ↑ Kitzmiller JL (1993). "Sweet success with diabetes. The development of insulin therapy and glycemic control for pregnancy". Diabetes Care. 16 Suppl 3: 107–21. PMID 8299468.
- ↑ Topcuoglu S, Karatekin G, Yavuz T, Arman D, Kaya A, Gursoy T, Ovalı F (2015). "The relationship between the oxidative stress and the cardiac hypertrophy in infants of diabetic mothers". Diabetes Res. Clin. Pract. 109 (1): 104–9. doi:10.1016/j.diabres.2015.04.022. PMID 25934526.