Gestational diabetes mellitus (class A): a human teratogen?

Area of Science:

• Medical Genetics
• Reproductive Medicine
• Teratology

Background:

• Maternal diabetes mellitus is a known risk factor for congenital anomalies.
• The teratogenic effects of pregestational diabetes are well-documented.
• The role of gestational diabetes mellitus in causing birth defects requires further investigation.

Purpose of the Study:

• To evaluate the frequency and types of anomalies in offspring of mothers with gestational diabetes mellitus.
• To compare the observed phenotypes with those associated with pregestational diabetes.
• To determine if gestational diabetes mellitus acts as a human teratogen.

Main Methods:

• Retrospective evaluation of 200 children from mothers with pregestational or gestational diabetes mellitus.
• Detailed dysmorphology assessment and exclusion of other known causes of malformations (chromosomal, monogenic, other teratogens).
• Phenotypic comparison with established diabetic embryopathy patterns.

Main Results:

• Eighty-seven out of 152 offspring (57%) of mothers with gestational diabetes exhibited anomalies consistent with diabetic embryopathy.
• Observed phenotypes mirrored those in offspring of mothers with pregestational diabetes (classes B2-T).
• Findings align with animal studies and epidemiological data suggesting a link between gestational diabetes and increased anomalies.

Conclusions:

• Gestational diabetes mellitus is inferred to be a human teratogen, contributing to birth defects during organogenesis.
• The embryopathy observed in gestational diabetes shares a similar pathogenesis with pregestational diabetes.
• Undiagnosed maternal gestational diabetes may be an underlying cause for many "idiopathic" malformations.