American Journal of Obstetrics & Gynecology
Volume 182, Issue 2 , Pages 313-320 , February 2000

Patterns of congenital anomalies and relationship to initial maternal fasting glucose levels in pregnancies complicated by type 2 and gestational diabetes

  • Ute M. Schaefer-Graf, MD

      Affiliations

    • Department of Obstetrics and Gynecology Los Angeles, California
    • University of Southern California School of Medicine, and the Department of Perinatal Medicine, Hospital Neukoelln, and the Department of Obstetrics, Charitè Campus Virchow-Klinikum, Humboldt University. Los Angeles, California
    • ,
  • Thomas A. Buchanan, MD

      Affiliations

    • Department of Obstetrics and Gynecology Los Angeles, California
    • Department of Medicine Los Angeles, California
    • ,
  • Anny Xiang, PhD

      Affiliations

    • Department of Preventive Medicine Los Angeles, California
    • ,
  • Giuliana Songster, MD

      Affiliations

    • Department of Obstetrics and Gynecology Los Angeles, California
    • ,
  • Martin Montoro, MD

      Affiliations

    • Department of Obstetrics and Gynecology Los Angeles, California
    • ,
  • Siri L. Kjos, MD

      Affiliations

    • Department of Obstetrics and Gynecology Los Angeles, California

Received 26 March 1999 ,Revised 2 August 1999 ,Accepted 23 September 1999.

References 

  1. Becerra JE, Khoury MJ, Cordero JF, Erikson JD. Diabetes mellitus during pregnancy and the risk of specific birth defects: a population-based case control study. Pediatrics. 1990;85:1–9
  2. Simpson JL, Elias S, Martin AO, Palmer MS, Ogata ES, Radvany RA. Diabetes in pregnancy, Northwestern University Series (1977-1981). I. Prospective study of anomalies in offspring of mothers with diabetes mellitus. Am J Obstet Gynecol. 1983;146:263–270
  3. Comess LJ, Bennett PH, Man MB, Burch TA, Miller M. Congenital anomalies and diabetes in the Pima Indians of Arizona. Diabetes. 1969;18:471–477
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  6. Mills JL, Knopp RH, Simpson JL, Jovanovic-Peterson L, Metzger BE, Holmes LB, et al.  Lack of relation of increased malformation rates in infants of diabetic mothers to glycemic control during organogenesis. N Engl J Med. 1988;318:671–676
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  11. Schaefer UM, Songster G, Xiang A, Berkowitz K, Buchanan TA, Kjos SL. Congenital malformations in offspring of women with hyperglycemia first detected during pregnancy. Am J Obstet Gynecol. 1997;177:1165–1171
  12. Metzger BE, Conference Organization Committee . Summary and Recommendations of the Second International Workshop Conference on Gestational Diabetes Mellitus. Diabetes. 1985;34(Suppl 2):123–125
  13. Metropolitan Atlanta Congenital Defect Program . Congenital malformations surveillance. Atlanta: Centers for Disease Control; 1988;
  14. Stevenson R, Hall J, Goodmann R. Human malformations and related anomalies. In:  Motulsky A,  Bobrow M,  Harper P,  Scriver C editor. Oxford Monographs on Medical Genetics No. 27. New York: Oxford University Press; 1993;p. 22–24
  15. Jones KL. Smith’s recognizable patterns of human malformations. In: 4th ed. Philadelphia: WB Saunders; 1988;p. 575; 602, 662-81
  16. Eriksson US, Dahlstrom E, Larsson KS, Hellerstrom C. Increased incidence of congenital malformations in the offspring of diabetic rates and their prevention by maternal insulin therapy. Diabetes. 1982;30:1–6
  17. Freinkel N, Cockroft DL, Lewis NJ, Gorman L, Akzawa S, Phillips LS, et al.  Fuel-medicated teratogenesis during early organogenesis: the effects of increased concentrations of glucose, ketones or somatomedin inhibitor during rat embryo culture. Am J Clin Nutr. 1986;44:986–995
  18. Rosenn B, Miodovnik M, Combs CA, Khoury J, Siddiqui TA. Glycemic threshold for spontaneous abortion and congenital malformations in insulin-dependent diabetes mellitus. Obstet Gynecol. 1994;84:515–520
  19. Hanson U, Persson B, Thunell S. Relationship between hemoglobin A1c in early type I (insulin-dependent) diabetic pregnancy and the occurrence of spontaneous abortion and fetal malformation in Sweden. Diabetologia. 1990;33:100–104

☆ Supported in part by grant M 01-RR43 from the General Clinical Research Center Branch, National Center for Research Resources, and the US National Institutes of Health.

☆☆ Reprint requests: Siri L. Kjos, MD, Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Women and Children’s Hospital, 1240 North Mission Rd, Rm L1017, Los Angeles, CA 90033.

PII: S0002-9378(00)70217-1

American Journal of Obstetrics & Gynecology
Volume 182, Issue 2 , Pages 313-320 , February 2000

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