Malformations in Infants of Diabetic Mothers

摘要: Maternal insulin-dependent diabetes has long been associated with congenital malformations. As other causes of mortality and morbidity have eliminated or reduced, malformations become increasingly prominent. Although there is not universal agreement, the great majority investigators find a two- to threefold increase in infants diabetic mothers. This seen gestational diabetics. It probably present women whose can be controlled by diet oral hypoglycemic agents. The risk does appear primarily genetic since fathers do an increased number malformed offspring. Most studies show generalized involving multiple organ systems. Multiple seem more common than non-diabetic infants. Caudal regression strongest association diabetes, occurring roughly 200 times frequently mothers teratogenic mechanism known. Hyperglycemia may important but human focusing on period organogenesis are lacking. Hypoglycemia also suggested based mainly animal experiments. Insulin appears unlikely. Numerous factors including vascular disease, hypoxia, ketone amino acid abnormalities, glycosylation proteins, hormone imbalances could teratogenic. None studied sufficient detail make judgment. A large-scale prospective study required determine early fetal loss rates, correlate metabolic status during outcome, assess effect control malformation rates.