Abstract
Introduction: Diabetes mellitus is a relatively common illness that can complicatepregnancy and result in an increased incidence of congenital malformations.Offspring of diabetic mothers suffering from type IDDM have a fivefold incidence of congenital malformations compared to pregnancies in the general healthy population. Specifically, the pattern of congenital heart disease(CHD) encountered among this group, with an emphasis on abnormalities of laterality, looping and conotruncal septation, suggesting that the maternal metabolic state affects cardiogenesis at a very early stage of the developmental period, prior to 7 weeks of gestation. Although many have been written on the effect of diabetes in pregnant women, less is known for the effects of type II DM and gestational diabetes mellitus(GDM) and its role in provoking CHD. Aim: Aim of this paper is to review the literature regarding the types of CHD seen in offspring of mothers suffering fromdifferent typesof diabetes mellitus, maternal types 1 and 2 and gestational and to comment on the incidences and any differencesfound in the types of detected CHD. Method: a systematic literature resurge of the last 15 years was reviewed focusing to produce answers on the aims of the study. Conclusion: basedon the existing evidencehigh frequency of CHD can be found in any type of maternal diabetes mellitus. For this reason, we believe that any type of diabetes present in a pregnancy must be a strong indication undergoing specific special fetal cardiac prenatal screening, aiming to detect possible CHD.
Highlights
Many studies have proven that offspring of diabetic mothers have a fivefold incidence of congenital malformations compared to pregnancies in the general healthy population [1,2].In the mid 1980’s the United Kingdom, the Diabetes Pregnancy Survey reported the presence of major congenital malformations, of which congenital heart disease(CHD) constituted a significant element of them
Other congenital malformations linked to maternal diabetes include Central Nervous System malformations that have been found 16 times more frequently seen in maternal Insulin Dependent Diabetes Mellitus(IDDM) or type I diabetes mellitus
Based on our data we reviewed from the resent existing literature, we believe that pregnancies complicated with gestational diabetes mellitus (GDM) present an increased risk of producing CHD
Summary
Many studies have proven that offspring of diabetic mothers have a fivefold incidence of congenital malformations compared to pregnancies in the general healthy population [1,2].In the mid 1980’s the United Kingdom, the Diabetes Pregnancy Survey reported the presence of major congenital malformations, of which congenital heart disease(CHD) constituted a significant element of them. Further CHD are the most important single causes of perinatal mortality amongst the offspring of diabetic mothers [3,4]. Other conditions as respiratory distress syndromegrowth abnormalities such as macrosomia (large for gestational age) and microsomia (small for gestational age), hyperviscosity syndrome secondary to polycythemia,hypoglycemic episodes due to unstable glucose compensating regulation, hypocalcemia, hypomagnesemia, and iron deficiency anemia increase morbidity and mortality risks in the immediate postnatal period [6]
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