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Pregestational diabetes in pregnancy: Complications, management, surveillance, and mechanisms of disease—A review
Author(s) -
Shub Alexis,
Lappas Martha
Publication year - 2020
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.5718
Subject(s) - medicine , pregnancy , diabetes mellitus , aneuploidy , fetus , disease , observational study , obstetrics , abortion , reproductive medicine , intensive care medicine , bioinformatics , endocrinology , biology , genetics , gene , chromosome
Diabetes is an increasingly common diagnosis among pregnant women. Pregestational diabetes is associated with an increase in many adverse pregnancy outcomes, which impact both on the woman and her fetus. The models of pregnancy care for women with diabetes are based largely on observational data or consensus opinion. Strategies for aneuploidy screening and monitoring for fetal well‐being should be modified in women with diabetes. There is an increasing understanding of the mechanisms by which congenital anomalies and disorders of fetal growth occur, involving epigenetic modifications, changes in gene expression in critical developmental pathways, and oxidative stress. This knowledge may lead to pathways for improved care for these high‐risk pregnancies.