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Infant of a diabetic mother

INTRODUCTION

Diabetes in pregnancy is associated with an increased risk of fetal, neonatal, and long-term complications in the offspring. Maternal diabetes may be pregestational (ie, type 1 or type 2 diabetes diagnosed before pregnancy with a prevalence rate of about 1.8 percent) or gestational (ie, diabetes diagnosed during pregnancy with a prevalence rate of about 7.5 percent). The outcome is generally related to the onset and duration of glucose intolerance during pregnancy and severity of the mother’s diabetes. (See "Pregnancy risks in women with type 1 and type 2 diabetes mellitus", section on 'Introduction'.)

This topic will review the complications seen in the offspring of mothers with diabetes and the management of affected neonates. The prenatal management of pregestational and gestational diabetic mothers is discussed in separate topic reviews. (See "Diabetes mellitus in pregnancy: Screening and diagnosis" and "Pregestational diabetes mellitus: Obstetrical issues and management" and "Gestational diabetes mellitus: Obstetrical issues and management" and "Gestational diabetes mellitus: Glycemic control and maternal prognosis" and "Pregnancy risks in women with type 1 and type 2 diabetes mellitus" and "Pregnancy risks in women with type 1 and type 2 diabetes mellitus", section on 'Fetal and neonatal complications'.)

FETAL EFFECTS

Poor glycemic control in pregnant diabetic women leads to deleterious fetal effects throughout pregnancy, as follows [1]:

In the first trimester and time of conception, maternal hyperglycemia can cause diabetic embryopathy resulting in major birth defects and spontaneous abortions. This primarily occurs in pregnancies with pregestational diabetes. (See 'Congenital anomalies' below and "Pregnancy risks in women with type 1 and type 2 diabetes mellitus", section on 'Fetal and neonatal complications'.)

Diabetic fetopathy occurs in the second and third trimesters, resulting in fetal hyperglycemia, hyperinsulinemia, and macrosomia.

                         

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Literature review current through: Jun 2014. | This topic last updated: May 12, 2014.
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