Airway Management in an Infant with Alobar Holoprosencephaly and Cebocephaly Associated with Maternal Diabetes Mellitus

Intrauterine fetal conditions can have lifelong cardiovascular effects. The impact of maternal diabetes mellitus on children’s cardiovascular profile is not well established. The goal of this study was to explore the association between maternal diabetes mellitus and offspring’s blood pressure (BP) ≤10 years of age. Generation XXI is a prospective birth cohort, which enrolled 8301 mother-offspring pairs, including 586 (7.1%) children of diabetic mothers. The associations between maternal diabetes mellitus and BP at 4, 7, and 10 years of age was modeled using linear regression. A mixed-effects model was built to assess differences in BP variation over time. Path analysis was used to quantify effects of potential mediators. Maternal diabetes mellitus was associated with higher BP in offspring at the age of 10 (systolic: β, 1.48; 95% CI, 0.36–2.59; and diastolic: β, 0.86; 95% CI, 0.05–1.71). This association was independent of maternal perinatal characteristics, and it was mediated by child’s body mass index and, to a lesser extent, by gestational age, type of birth, and birth weight (indirect effect proportion, 73%). No significant differences in BP were found at 4 and 7 years of age. Longitudinal analysis showed an accelerated systolic BP increase on maternal diabetes mellitus group (β, 1.16; 95% CI, 0.03–2.28). These finding were especially relevant in males, suggesting sex differences in the mechanisms of BP prenatal programing. Our results provide further evidence that maternal diabetes mellitus is associated with high BP late in childhood, demonstrating a significant role of child’s body mass in the pathway of this association.

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Doppler studies in pregnancies with maternal diabetes mellitus

Placental and Fetal Doppler ◽

10.1201/b14685-9 ◽

2000 ◽

pp. 121-133

Keyword(s):

Diabetes Mellitus ◽

Maternal Diabetes ◽

Doppler Studies ◽

Maternal Diabetes Mellitus

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Echocardiographic Study of Congenital Heart Disease in Infants of Diabetic Mother

Journal of Nobel Medical College ◽

10.3126/jonmc.v8i1.24476 ◽

2019 ◽

Vol 8 (1) ◽

pp. 43-47

Author(s):

Babita Khanal ◽

Manoj Kumar Shrivastava ◽

Prakash Kafle ◽

Pushpa Kumari Shah

Keyword(s):

Diabetes Mellitus ◽

Congenital Heart Disease ◽

Risk Factor ◽

Heart Disease ◽

Congenital Heart ◽

College Teaching ◽

Maternal Diabetes ◽

Diabetic Mother ◽

Medical College ◽

Maternal Diabetes Mellitus

Background: Maternal diabetes mellitus (DM) has been shown to be high risk factor for congenital anomalies. It carries 3-5 times higher risk of incidence compared to the general population. The aims of present study is to investigate and portray the incidence of congenital heart disease in infants of diabetic mothers and know the utility of echocardiography in the early diagnosis of CHD at Nobel Medical College teaching hospital, a tertiary care centre in the eastern part of Nepal and review the current literature. Material & Methods: This is a prospective observational study conducted in Nobel Medical College Teaching hospital, Kanchanbari, Biratnagar Nepal over the period of 12 months. A structured questionnaire was designed which included demographic profile and the Echocardiography findings. The collected data were analysed using window’s SPSS version 20. Results: In the present study of the total deliveries 1.99 % was diabetic mother comprising 208 deliveries.127 had undergone echocardiography in which 10.2 % (n=13) had anomalies. One hundred sixteen were term and 11 were preterm. PDA was the most common anomaly (38.4%) followed by VSD (23.1%) and HCM (15.4%). Conclusion: With the review of current literature it has been found that maternal diabetes mellitus is a significant risk factor for congenital heart disease so it is suggested that the presence of diabetes mellitus in a pregnancy should be taken as a strong suspicious of having CHD and infants should be screened for the same .so as to diagnose the anomaly at the earliest possible.

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Metabolic Profiling in Blastocoel Fluid and Blood Plasma of Diabetic Rabbits

International Journal of Molecular Sciences ◽

10.3390/ijms21030919 ◽

2020 ◽

Vol 21 (3) ◽

pp. 919 ◽

Cited By ~ 1

Author(s):

Maria Schindler ◽

Sophia Mareike Pendzialek ◽

Katarzyna Grybel ◽

Tom Seeling ◽

Anne Navarrete Santos

Keyword(s):

Diabetes Mellitus ◽

Blood Plasma ◽

Embryo Development ◽

Maternal Diabetes ◽

Diabetic Group ◽

Insulin Dependent Diabetes ◽

Dependent Diabetes Mellitus ◽

Maternal Metabolism ◽

Insulin Dependent ◽

Maternal Diabetes Mellitus

Metabolic disorders of the mother adversely affect early embryo development, causing changes in maternal metabolism and consequent alterations in the embryo environment in the uterus. The goal of this study was to analyse the biochemical profiles of embryonic fluids and blood plasma of rabbits with and without insulin-dependent diabetes mellitus (DT1), to identify metabolic changes associated with maternal diabetes mellitus in early pregnancy. Insulin-dependent diabetes was induced by alloxan treatment in female rabbits 10 days before mating. On day 6 post-coitum, plasma and blastocoel fluid (BF) were analysed by ultrahigh performance liquid chromatography-tandem mass spectroscopy (UPLC-MS/MS) (Metabolon Inc. Durham, NC, USA). Metabolic datasets comprised a total of 284 and 597 compounds of known identity in BF and plasma, respectively. Diabetes mellitus had profound effects on maternal and embryonic metabolic profiles, with almost half of the metabolites changed. As predicted, we observed an increase in glucose and a decrease in 1,5-anhydroglucitol in diabetic plasma samples. In plasma, fructose, mannose, and sorbitol were elevated in the diabetic group, which may be a way of dealing with excess glucose. In BF, metabolites of the pentose metabolism were especially increased, indicating the need for ribose-based compounds relevant to DNA and RNA metabolism at this very early stage of embryo development. Other changes were more consistent between BF and plasma. Both displayed elevated acylcarnitines, body3-hydroxybutyrate, and multiple compounds within the branched chain amino acid metabolism pathway, suggesting that lipid beta-oxidation is occurring at elevated levels in the diabetic group. This study demonstrates that maternal and embryonic metabolism are closely related. Maternal diabetes mellitus profoundly alters the metabolic profile of the preimplantation embryo with changes in all subclasses of metabolites.

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Erratum to: 4 INFLUENCE OF A MATERNAL DIABETES MELLITUS TYPE 1 ON LIPID AND CHOLESTEROL METABOLISM IN RABBIT PRE-IMPLANTATION EMBRYOS

Reproduction Fertility and Development ◽

10.1071/rdv25n1ab4 ◽

2013 ◽

Vol 25 (1) ◽

pp. 149

Author(s):

M. Schindler ◽

M. Pendzialek ◽

T. Plösch ◽

J. M. Knelangen ◽

J. Gürke ◽

...

Keyword(s):

Diabetes Mellitus ◽

Fatty Acid ◽

Lipid Metabolism ◽

Embryo Development ◽

Maternal Diabetes ◽

Early Embryo ◽

Cholesterol Concentration ◽

Early Embryo Development ◽

Diabetic Rabbits ◽

Maternal Diabetes Mellitus

The incidence of overweight and obesity has reached epidemic levels worldwide. Even more alarming is the increasing prevalence of metabolic diseases in younger children and adolescents. The rate of women with diabetes mellitus in child-bearing age is rising, too. According to the developmental origins of health and disease (DOHaD) paradigm, exposure to a hyperglycaemic environment in utero may programme physiology and metabolism permanently, with long-term consequences for offspring health. Experimental evidence indicates that programming of obesity does occur during early embryo development, a period where many women are unaware of pregnancy. To study effects of maternal diabetes mellitus on early embryo development, we induced a type I diabetes through alloxan treatment of female rabbits. In diabetic rabbits, the triglyceride and cholesterol concentrations were altered in serum and the cholesterol concentration in the uterine secretions was elevated. Lipid content of 6-day-old blastocysts was analysed after Oil Red staining and whole mount histochemistry or with Nile Red by fluorescence-activated cell sorting (FACS). Analysis by FACS revealed an approximately 2-fold increase in lipid droplets in blastocysts grown under diabetic conditions. The expression of genes important for lipid metabolism, such as fatty acid transport protein 4 (FATP4), fatty acid-binding protein 4 (FABP4), carnitine palmitoyltransferase 1 (CPT-1), and lipoprotein lipase (LPL), were determined by real-time PCR and showed distinct differences between diabetic and control blastocysts. Immunohistochemical staining of FABP4 was clearly increased in blastocysts grown under diabetic conditions and showed a cell lineage-specific distribution. Two transcription factors, peroxisome proliferator-activated receptor α (PPARα) and PPARγ, with key functions in lipid metabolism and adipogenic differentiation, were increased in blastocysts from diabetic rabbits. We show that maternal diabetes mellitus leads to alteration in lipid metabolism and to triglyceride accumulation in blastocysts. Its long-lasting consequences (e.g. for adipose cell differentiation) need attention and further investigation.

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