The child of the diabetic mother

Abstract

Carbohydrate Intolerance affects 1% to 20% of gestations and It Is associated to a high Index of neonatal morbidity. The technological resources allow for an optimal control and therefore better up the fetoneonatal result. Among the complications of the offspring of diabetic mother, macrosomy keeps on being a disarrangement of difficult prevention.

The fast metabolic changes during pregnancy modify the fetal response and promote an Increase of growth factors such as Insulin. The different nutrients (glucose, aminoacids, Lipids) might cross over the placenta in a variable manner, at this point there's a gradient concentration between the maternal and fetal glycaemia (15%-25%). The obvious fetal response to hyperglycemic stimuli is an Increase of Insulinic receptors (up regulation).

Others problems that affect the perinatal results are discussed and their physiopathological implications are presented (eg, respiratory distress syndrome, fetal hypoxia).

The placenta and endocrine organ affects the maternal economic and the fetal environment, with the potential alterations on the embryological critical period. At this moment, the embryo is glycolytic way dependent and growth factors responding. Therefore, this phase of development is very susceptible to the internal milieu and is the critical period for congenital malformations. (4 to 10 folds the usual incidence). It's Important to note that in this moment there are several diabetic women, detected or not, beginning their pregnancies with metabolic disturbances. Furthermore, it’s necessary to Insist on the metabolic evaluation darling pregnancy and preconception counseling.