Fetal cardiac effects of maternal hyperglycemia during pregnancy
Article first published online: 29 JAN 2009
Copyright © 2009 Wiley-Liss, Inc.
Birth Defects Research Part A: Clinical and Molecular Teratology
Volume 85, Issue 6, pages 523–530, June 2009
How to Cite
Corrigan, N., Brazil, D. P. and McAuliffe, F. (2009), Fetal cardiac effects of maternal hyperglycemia during pregnancy. Birth Defects Research Part A: Clinical and Molecular Teratology, 85: 523–530. doi: 10.1002/bdra.20567
- Issue published online: 9 JUN 2009
- Article first published online: 29 JAN 2009
- Manuscript Accepted: 2 DEC 2008
- Manuscript Revised: 1 DEC 2008
- Manuscript Received: 19 SEP 2008
- Irish Health Research Board and University College Dublin
- Science Foundation Ireland
- Irish Health Research Board
- UCD Conway Institute is funded by the Programme for Reserach in Third Level Institutions in Ireland
- Higher Education Authority (HEA)
Maternal diabetes mellitus is associated with increased teratogenesis, which can occur in pregestational type 1 and type 2 diabetes. Cardiac defects and with neural tube defects are the most common malformations observed in fetuses of pregestational diabetic mothers. The exact mechanism by which diabetes exerts its teratogenic effects and induces embryonic malformations is unclear. Whereas the sequelae of maternal pregestational diabetes, such as modulating insulin levels, altered fat levels, and increased reactive oxygen species, may play a role in fetal damage during diabetic pregnancy, hyperglycemia is thought to be the primary teratogen, causing particularly adverse effects on cardiovascular development. Fetal cardiac defects are associated with raised maternal glycosylated hemoglobin levels and are up to five times more likely in infants of mothers with pregestational diabetes compared with those without diabetes. The resulting anomalies are varied and include transposition of the great arteries, mitral and pulmonary atresia, double outlet of the right ventricle, tetralogy of Fallot, and fetal cardiomyopathy.
A wide variety of rodent models have been used to study diabetic teratogenesis. Both genetic and chemically induced models of type 1 and 2 diabetes have been used to examine the effects of hyperglycemia on fetal development. Factors such as genetic background as well as confounding variables such as obesity appear to influence the severity of fetal abnormalities in mice. In this review, we will summarize recent data on fetal cardiac effects from human pregestational diabetic mothers, as well as the most relevant findings in rodent models of diabetic cardiac teratogenesis. Birth Defects Research (Part A), 2009. © 2009 Wiley-Liss, Inc.