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Maternal Diabetes (maternal + diabetes)
Terms modified by Maternal Diabetes Selected AbstractsMaternal blood glucose in diabetic pregnancies and cognitive performance in offspring in young adulthood: a Danish cohort studyDIABETIC MEDICINE, Issue 7 2010G. L. Nielsen Diabet. Med. 27, 786,790 (2010) Abstract Aims, Maternal diabetes is a known risk factor for perinatal complications, but there are little data on consequences for long-term intellectual outcome in offspring. We assess cognitive performance in military conscripts according to maternal blood glucose levels during pregnancy. Methods, We identified a cohort of 60 Danish male offspring of insulin-treated diabetic mothers born between 1976 and 1984 and followed this cohort to military conscription. From medical records, we extracted data on all available values of maternal blood glucose categorized as fasting and non-fasting and by day in pregnancy, together with maternal White class, smoking habits and socio-economic status. The main outcome was cognitive performance at conscription measured with a validated intelligence test. The association between maternal blood glucose level and cognitive performance was assessed by multivariate linear regression and a fitted fractional polynomial. Results, Median fasting blood glucose values in the second half of pregnancy was negatively associated with cognitive scores at conscription [adjusted coefficient ,1.7; 95% confidence interval (CI) ,3.0; ,0.4]. Restriction to only first-born sibling slightly strengthened the association (coefficient ,1.9; 95% CI ,3.3; ,0.5), but after exclusion of two pregnancies with the blood glucose > 10 mmol/l the association became insignificant (coefficient ,0.6; 95% CI ,2.6; 1.4). Conclusions, Maternal blood glucose level during diabetic pregnancy is negatively associated with cognitive performance in offspring at military conscription. In pregnancies with fasting blood glucose levels below 10 mmol/l, the association is weak and considered to be without clinical relevance. [source] The reproductive health of daughters of pregestational diabetic women: Medical Birth Registry of NorwayPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 4 2002Grace M. Egeland Summary Maternal diabetes may have an impact upon a daughter's reproductive health through genetic influences, an altered fetal metabolic environment or both. We examined the reproductive health of daughters of diabetic women using linked generation data from the Medical Birth Registry of Norway. Among all female births between 1967 and 1982 (n = 459 182), 739 had a mother with registered pregestational diabetes, a rate of 1.6 per 1000 deliveries. A total of 142 904 daughters delivered at least one child by 1998. After taking into account differences in survival, we observed no differences in the percentage of childbearing and in the average number of children born by 1998 between daughters with and without a diabetic mother in age-stratified analyses. In analyses limited to singleton deliveries and stratified by mothers' and daughters' diabetic status, we found a threefold excess stillbirth delivery rate among women who had either a mother with pregestational diabetes (2.6%) or pregestational diabetes themselves (2.6%) compared with the stillbirth delivery rate observed in non-diabetic women with no maternal history of diabetes (0.8%). These findings were unaltered in multivariable analyses adjusting for daughters' maternal age and registered obstetric risk factors. Our results indicate that pregestational diabetes remains a health care challenge in Norway and that further evaluation of the reproductive health of daughters of diabetic pregnancies is warranted. [source] Maternal diabetes and renal agenesis/dysgenesis,,BIRTH DEFECTS RESEARCH, Issue 9 2010Erin M. Davis Abstract BACKGROUND: Renal agenesis and dysgenesis are potentially lethal congenital malformations affecting 2 to 5 infants per 10,000 live births annually in the United States. The low prevalence of these malformations has complicated understanding of potential risk factors. Maternal diabetes (type 1, type 2, and gestational) has been evaluated extensively as a risk factor for other congenital malformations, but only a limited number of studies have assessed the association between diabetes and renal agenesis. METHODS: We conducted a population-based case-control study of deliveries after 20 weeks gestation in Texas Health Service Region 6 (Houston/Galveston area) from January 1, 2000 to December 31, 2002. Cases of renal agenesis/dysgenesis (n = 89) were ascertained from the Texas Birth Defects Registry. Cumulative incidence sampling was used to randomly select, from birth and fetal death records, 356 controls frequency matched to cases by delivery year and vital status. Maternal diabetes and other covariates were collected from vital records. RESULTS: The odds of renal agenesis/dysgenesis were 3.1 (95% confidence interval [CI], 1.1,9.3) times greater among deliveries of mothers with diabetes compared to deliveries of mothers without diabetes, controlling for matching factors. CONCLUSIONS: Our results are consistent with prior, but limited, research identifying diabetes as a risk factor for renal agenesis/dysgenesis. While these data did not differentiate diabetes diagnoses by type, the results suggest that maternal diabetes may be associated with renal malformations. Further study is warranted. Birth Defects Research (Part A), 2010. © 2010 Wiley-Liss, Inc. [source] Disturbed morphogenesis of cardiac outflow tract and increased rate of aortic arch anomalies in the offspring of diabetic ratsBIRTH DEFECTS RESEARCH, Issue 12 2004Daniël G.M. Molin Abstract BACKGROUND Maternal diabetes (MD) is a risk factor for offspring to develop cardiovascular anomalies; this is of growing clinical concern since the number of women in childbearing age with compromised glucose homeostasis is increasing. Hyperglycemia abrogates cardiovascular development in vitro; however, a link to cardiovascular defects in diabetic offspring remains to be investigated. METHODS We have studied cardiovascular development in offspring of MD rats by examining serial histological sections of GD 12.0,18.0 offspring. Development of pharyngeal arch artery malformations was analyzed and related to intracardiac anomalies. RESULTS Pharyngeal arch artery and intracardiac defects were present in 27 of 37 MD GD 13.0,18.0 offspring. Early sixth arch arteries showed abrogated arteriogenesis, whereas fourth arch artery defects developed as a result of abnormal remodeling. Morphometrical analysis showed increased apoptosis in regressing artery segments and reduced apoptosis in persisting artery segments. Double outlet right ventricle with infundibular stenosis (tetralogy of Fallot) was predominantly found in combination with sixth artery defects and pulmonary atresia. As confirmed by morphometric analysis and three-dimensional (3D)-reconstructions, outflow tract defects coincided with endocardial cushion hypoplasia. Cases with teratology of Fallot additionally showed a shorter outflow tract. No relation with apoptosis or disturbed neural crest cell migration was found. CONCLUSIONS Our data uniquely demonstrate mechanistic differences involved in the development of sixth and fourth artery anomalies. Whereas increased apoptosis induces fourth artery anomalies, pulmonary outflow obstruction abrogates sixth artery differentiation independent of apoptosis. The model presented allows analysis of diabetic conditions on cardiovascular development in vivo, essential for elucidating this teratology. Birth Defects Research (Part A), 2004. © 2004 Wiley-Liss, Inc. [source] Maternal diabetes and malformationsBIRTH DEFECTS RESEARCH, Issue 1 2002Harold Kalter No abstract is available for this article. [source] Fetal cyclic motor activity in diabetic pregnancies: Sensitivity to maternal blood glucoseDEVELOPMENTAL PSYCHOBIOLOGY, Issue 1 2003Steven S. Robertson Abstract Spontaneous fetal movement in the last third of human gestation is dominated by irregular oscillations on a scale of minutes (cyclic motility, CM). The core properties of these oscillations are stable during the third trimester of gestation in normal fetuses, but disrupted by poorly controlled maternal diabetes. Here we investigated whether fetal CM is linked to short-term instabilities in maternal glucose metabolism. The fetuses of 40 mothers with type I (n,=,28) or gestational (n,=,12) diabetes were studied one to six times between 27 and 40 postmenstrual weeks of gestation. Fetal movement and maternal blood glucose concentration were measured during two separate periods of fetal activity in each session. Fetal CM was quantified with spectral analysis. Early in the third trimester, changes in the rate of oscillation in fetal CM between the two periods of activity were inversely related to changes in maternal blood glucose levels. Fetal CM was unrelated to concurrent maternal blood glucose levels at any point in the third trimester. The pattern of results suggests that disruption of the temporal organization of spontaneous fetal motor activity in pregnancies complicated by maternal diabetes represents an acute response to fluctuations in the metabolic environment rather than an alteration of CM development. © 2003 Wiley Periodicals, Inc. Dev Psychobiol 42: 9,16, 2003. [source] Genetic considerations in the prenatal diagnosis of overgrowth syndromesPRENATAL DIAGNOSIS, Issue 10 2009Neeta Vora Abstract Large (>90%) for gestational age (LGA) fetuses are usually identified incidentally. Detection of the LGA fetus should first prompt the provider to rule out incorrect dates and maternal diabetes. Once this is done, consideration should be given to certain overgrowth syndromes, especially if anomalies are present. The overgrowth syndromes have significant clinical and molecular overlap, and are associated with developmental delay, tumors, and other anomalies. Although genetic causes of overgrowth are considered postnatally, they are infrequently diagnosed prenatally. Here, we review prenatal sonographic findings in fetal overgrowth syndromes, including Pallister-Killian, Beckwith-Wiedemann, Sotos, Perlman, and Simpson-Golabi-Behmel. We also discuss prenatal diagnosis options and recurrence risks. Copyright © 2009 John Wiley & Sons, Ltd. [source] Association of Maternal Chronic Disease and Negative Birth Outcomes in a Non-Hispanic Black-White Mississippi Birth CohortPUBLIC HEALTH NURSING, Issue 4 2007Juanita Graham ABSTRACT Objective: To investigate the impact of selected maternal chronic medical conditions, race, and age on preterm birth (PTB), low birth weight (LBW), and infant mortality among Mississippi mothers from 1999 to 2003. Design: A retrospective cohort analysis of linked birth and death certificates. Sample: The 1999,2003 Mississippi birth cohort comprising 202,931 singleton infants born to African American and White women. Measurements: The relationship between maternal chronic conditions and the dependent variables of PTB, LBW, and infant mortality were investigated using logistic regression analysis. Results: PTB, LBW, and infant mortality were more prevalent among African American women, very young women (,15 years), and women with certain chronic medical conditions. Among White mothers, maternal chronic hypertension was significantly associated with PTB and LBW, and maternal diabetes with PTB and infant mortality. Among African American mothers, maternal cardiac disease was significantly associated with PTB and LBW; maternal chronic hypertension was significantly associated with LBW and infant mortality; and maternal diabetes with PTB. Conclusions: Maternal chronic hypertension and diabetes were significantly associated with negative birth outcomes regardless of maternal race. Maternal cardiac disease was only significantly associated with PTB and LBW among African Americans. [source] Neonatal hyperinsulinaemic hypoglycaemia and monogenic diabetes due to a heterozygous mutation of the HNF4A geneAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2009Jennifer J. CONN Recent research has demonstrated that mutations of the hepatocyte nuclear factor 4-alpha (HNF4A) gene are associated with neonatal hyperinsulinaemic hypoglycaemia. Mutations of this gene also cause one of the subtypes of monogenic diabetes, a form of diabetes formerly known as maturity-onset diabetes of the young. This article describes a family discovered to have a novel frame-shift mutation of the HNF4A gene in the setting of early-onset maternal diabetes and severe neonatal hyperinsulinaemic hypoglycaemia. The implications of a diagnosis of HNF4A gene mutation for obstetric and paediatric practice are discussed. [source] Maternal diabetes and renal agenesis/dysgenesis,,BIRTH DEFECTS RESEARCH, Issue 9 2010Erin M. Davis Abstract BACKGROUND: Renal agenesis and dysgenesis are potentially lethal congenital malformations affecting 2 to 5 infants per 10,000 live births annually in the United States. The low prevalence of these malformations has complicated understanding of potential risk factors. Maternal diabetes (type 1, type 2, and gestational) has been evaluated extensively as a risk factor for other congenital malformations, but only a limited number of studies have assessed the association between diabetes and renal agenesis. METHODS: We conducted a population-based case-control study of deliveries after 20 weeks gestation in Texas Health Service Region 6 (Houston/Galveston area) from January 1, 2000 to December 31, 2002. Cases of renal agenesis/dysgenesis (n = 89) were ascertained from the Texas Birth Defects Registry. Cumulative incidence sampling was used to randomly select, from birth and fetal death records, 356 controls frequency matched to cases by delivery year and vital status. Maternal diabetes and other covariates were collected from vital records. RESULTS: The odds of renal agenesis/dysgenesis were 3.1 (95% confidence interval [CI], 1.1,9.3) times greater among deliveries of mothers with diabetes compared to deliveries of mothers without diabetes, controlling for matching factors. CONCLUSIONS: Our results are consistent with prior, but limited, research identifying diabetes as a risk factor for renal agenesis/dysgenesis. While these data did not differentiate diabetes diagnoses by type, the results suggest that maternal diabetes may be associated with renal malformations. Further study is warranted. Birth Defects Research (Part A), 2010. © 2010 Wiley-Liss, Inc. [source] Wnt signaling in caudal dysgenesis and diabetic embryopathyBIRTH DEFECTS RESEARCH, Issue 10 2008Gabriela Pavlinkova Abstract BACKGROUND: Congenital defects are a major complication of diabetic pregnancy, and the leading cause of infant death in the first year of life. Caudal dysgenesis, occurring up to 200-fold more frequently in children born to diabetic mothers, is a hallmark of diabetic pregnancy. Given that there is also an at least threefold higher risk for heart defects and NTDs, it is important to identify the underlying molecular mechanisms for aberrant embryonic development. METHODS: We have investigated gene expression in a transgenic mouse model of caudal dysgenesis, and in a pharmacological model using situ hybridization and quantitative real-time PCR. RESULTS: We identified altered expression of several molecules that control developmental processes and embryonic growth. CONCLUSIONS: The results from our models point towards major implication of altered Wnt signaling in the pathogenesis of developmental anomalies associated with embryonic exposure to maternal diabetes. Birth Defects Research (Part A) 82:710,719, 2008. © 2008 Wiley-Liss, Inc. [source] Case-control study confirms the diagnosis-specific risk of maternal diabetes: Reply to Harold KalterBIRTH DEFECTS RESEARCH, Issue 1 2002Christopher A. Loffredo No abstract is available for this article. [source] Recurrence of breech presentation in consecutive pregnanciesBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 7 2010JB Ford Please cite this paper as: Ford J, Roberts C, Nassar N, Giles W, Morris J. Recurrence of breech presentation in consecutive pregnancies. BJOG 2010;117:830,836. Objective, To investigate the recurrence risk of breech presentation at term, and to assess the risk factors that contribute to its recurrence. Design, Cohort study. Setting, New South Wales, Australia. Population, Women with their first two (n = 113 854) and first three (n = 21 690) consecutive singleton term pregnancies, in the period 1994,2002. Methods, Descriptive statistics including rates, relative risks and adjusted relative risks, as determined from logistic regression and Poisson analyses. Main outcome measures, Rates and risks of occurrence and recurrence of breech presentation at birth in each pregnancy, and maternal and infant risk factors associated with breech recurrence. Results, First-time breech presentation at term occurred in 4.2% of first pregnancy deliveries, 2.2% of second pregnancies and 1.9% of third pregnancies. The rate of breech recurrence in a second consecutive pregnancy was 9.9%, and in a third consecutive pregnancy (after two prior breech deliveries) was 27.5%. The relative risk of breech recurrence in a second pregnancy was 3.2 (95% CI 2.8,3.6), and in a third consecutive breech pregnancy was 13.9 (95% CI 8.8,22.1). First pregnancy factors associated with recurrence included placenta praevia [adjusted relative risk (aRR) 2.2; 95% CI 1.3,3.7], maternal diabetes (aRR 1.4; 95% CI 1.0,2.1) and a maternal age of ,35 years (aRR 1.2; 95% CI 0.9,1.6). Second pregnancy factors included birth defects (aRR 2.5; 95% CI 1.4,4.2), placenta praevia (aRR 2.5; 95% CI 1.5,4.1) and a female infant (aRR 1.2; 95% CI 1.0,1.5). Conclusions, The increased recurrence risk of breech presentations suggests that women with a history of breech delivery should be closely monitored in the latter stages of pregnancy. [source] | |||||||||||||