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The diabetic pregnancy, macrosomia, and perinatal nutritional programming
A Plagemann1, T Harder, J W Dudenhausen
1Clinic of Obstetrics, Research Group Experimental Obstetrics, Charité University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany. andreas.plagemann@charite.de
Nestle Nutrition Workshop Series. Paediatric Programme
|January 17, 2008
Summary
Early life nutrition and hormones, like insulin, can program future health. Offspring of diabetic mothers (ODM) show that high perinatal insulin may lead to obesity and diabetes later in life.
Area of Science:
- Developmental programming
- Endocrinology
- Metabolic disorders
Background:
- Genetic factors are traditionally viewed as primary causes of disease.
- Emerging evidence highlights the critical role of intrauterine and early postnatal environments in disease predisposition.
- Studies on offspring of diabetic mothers (ODM) provide key insights into these mechanisms.
Purpose of the Study:
- To investigate the role of perinatal hormonal environment, specifically hyperinsulinism, in programming later-life metabolic disorders.
- To explore the impact of maternal diabetes and early overfeeding on offspring health outcomes.
- To propose primary prevention strategies for obesity and diabetes.
Main Methods:
- Utilized epidemiological, clinical, and experimental data focusing on offspring of diabetic mothers (ODM).
- Examined the effects of elevated insulin concentrations during perinatal development.
- Analyzed the influence of maternal overweight and neonatal overfeeding.
Main Results:
- Fetal and neonatal hyperinsulinism is a characteristic feature in ODM.
- Elevated perinatal insulin levels are implicated in programming the development of obesity and diabetes.
- Maternal overweight and neonatal overfeeding may create similar programming effects.
Conclusions:
- Perinatal hormonal milieu, particularly hyperinsulinism, acts as an endogenous teratogen, programming future metabolic disease.
- Maternal diabetes and early overfeeding are significant risk factors for lifelong health.
- Screening for diabetes in pregnancy and avoiding early postnatal overfeeding are recommended primary prevention strategies.
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