Abstract
Congenital anomalies may be determined by genetic or environmental factors or a combination of the two factors. Maternal disease can affect fetal development through specific effects of metabolic products or maternal antibody transfer. Identifying mothers and pregnancies at risk as well as providing a teratogenic risk discussion and appropriate documentation is aimed at reducing potential teratogenic effects of maternal diseases.
Highlights
Congenital anomalies may be determined by genetic or environmental factors or a combination of the two factors
Maternal obesity during pregnancy is associated with adverse outcomes that include macrosomia, hypertension, pre-eclampsia, gestational diabetes mellitus and fetal death. [4,5,6] Some studies indicates that maternal obesity could lead to perturbation of the normal development and maturation of the immune system of the fetus in utero
Hyperglycemia leads to myoinositol uptake inhibition that is essential for embryonic mitosis and development of neural tube. [9,10] Maternal pregnancy-associated plasma protein-A seems to be a biomarker for maternal diabetes and large-for-gestational-age newborn. [11]
Summary
Birth defects in diabetic pregnancy is 10%, higher than the general population (3%). [9,10] Maternal pregnancy-associated plasma protein-A seems to be a biomarker for maternal diabetes and large-for-gestational-age newborn. Some studies notice a correlation between elevated hemoglobin A1c (HbA1c) levels and the incidence of major congenital anomalies in infants of diabetic mothers. In 66% of the offspring: transposition of the great vessels, ventricular septal defect (VSD), and dextrocardia are the most common heart anomalies, anencephaly, spina bifida, and hydrocephaly are the major nervous system malformations. [14] It seems that maternal diabetes affects the temporal expression pattern of gene encoding molecules involved in heart development. With varying degrees of sacral agenesis, is occasionally associated with defects of the palate and branchial arches and occurs in 1% of diabetic offspring. With varying degrees of sacral agenesis, is occasionally associated with defects of the palate and branchial arches and occurs in 1% of diabetic offspring. [16,17] In 2015, Xiang AH et al suggest a correlation between maternal diabetes and autism spectrum disorders. [18]
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