The offspring of gestational diabetes
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M. R.G. Carrapato
Abstract
Gestational diabetes mellitus (GDM) usually develops in the second half of pregnancy and, in order to address the impact of GDM on the conceptus, several issues must be raised: what are the immediate implications for the fetus and the neonate and why do they happen? What are the consequences for the offspring? What can be done? In a theoretical model the whole pathogenesis and spectrum of fetal and neonatal mortality and morbidity could primarily be attributed to the excessive transferal of glucose from mother to fetus, inducing fetal hyperglycemia, leading to fetal pancreatic islet hypertrophy and β-cell hyperplasia with a consequent rise in insulin secretion. However, besides, and in addition to glucose, it is quite possible that other metabolic fuels, from amino acids to lipids, may also cross the placenta further contributing to the adverse intrauterine environment. Depending upon the time of gestation during critical developmental stages, the same metabolic fuels would have different effects upon the fetus, the neonate and quite possibly, upon the long-term outcome from neurological and psychosocial impairment to the adult development of metabolic and cardiovascular disorders
Based on clinical and experimental evidence that poor maternal homeostasis is at the core of the problem, it is of paramount importance to identify women at risk of GDM and to keep a tight metabolic control in order to avoid immediate and long-term consequences for their offspring.
Copyright © 2003 by Walter de Gruyter GmbH & Co. KG
Articles in the same Issue
- The offspring of gestational diabetes
- Matrix metalloproteinase 3 in parturition, premature rupture of the membranes, and microbial invasion of the amniotic cavity
- Levels of lipoprotein(a) in normal and compromised pregnancy
- Elevated risk for neonatal outcome following denial of pregnancy: results of a one-year prospective study compared with control groups
- Toxoplasmosis in pregnancy is still an open subject
- Uterine contraction frequency during treatment of pyelonephritis in pregnancy and subsequent risk of preterm birth
- Behaviour of β2-adrenoceptors on lymphocytes under continuous and pulsatile tocolysis with Fenoterol
- Maternal and fetal plasma endothelin levels in intrauterine growth restriction: relation to umbilical artery Doppler flow velocimetry
- Early markers of late-onset sepsis in premature neonates: clinical, hematological and cytokine profile
- CSF findings in neonates with seizures; infectious and noninfectious
- Viral infections in neonates with seizures
- New transcutaneous jaundice device with two optical paths
- Congress Calendar
- Roster of Perinatal Societies
- WAPM-Newsletter No 1/2003
Articles in the same Issue
- The offspring of gestational diabetes
- Matrix metalloproteinase 3 in parturition, premature rupture of the membranes, and microbial invasion of the amniotic cavity
- Levels of lipoprotein(a) in normal and compromised pregnancy
- Elevated risk for neonatal outcome following denial of pregnancy: results of a one-year prospective study compared with control groups
- Toxoplasmosis in pregnancy is still an open subject
- Uterine contraction frequency during treatment of pyelonephritis in pregnancy and subsequent risk of preterm birth
- Behaviour of β2-adrenoceptors on lymphocytes under continuous and pulsatile tocolysis with Fenoterol
- Maternal and fetal plasma endothelin levels in intrauterine growth restriction: relation to umbilical artery Doppler flow velocimetry
- Early markers of late-onset sepsis in premature neonates: clinical, hematological and cytokine profile
- CSF findings in neonates with seizures; infectious and noninfectious
- Viral infections in neonates with seizures
- New transcutaneous jaundice device with two optical paths
- Congress Calendar
- Roster of Perinatal Societies
- WAPM-Newsletter No 1/2003
