A Kozma1, V Radoi2, R Ursu2, C L Bohaltea2, H Lazarescu3, S Carniciu4. 1. "Alessandrescu - Russescu" National Institute for Mother and Child Health - Research Department in Social Pediatrics and Obstetrics, Bucharest, Romania. 2. "Carol Davila" University of Medicine and Pharmacy Faculty of Medicine - Medical Genetics, Bucharest, Romania. 3. National Institute of Rehabilitation, Physical Medicine and Balneology, Bucharest, Romania. 4. Center for Research, Diagnosis and Treatment in Diabetes and Metabolic Diseases Corposana, Bucharest, Romania.
Abstract
BACKGROUND: Several studies observed metabolic disorders in pregnancy as risk factors for birth defects, including orofacial clefts. Diabetes is associated with approx. 10% of the pregnancies, but in Romania, less than 5%. An obese and diabetic woman has 3 times more risk for an offspring with a craniofacial defect than healthy women suggesting that diabetes mellitus contributes to their pathogenesis with complex mechanisms. CASE REPORT: We present the case of a newborn 4 days old, male with neonatal hypoglycemia, cleft lip and proportionate (symmetric) macrosomia. His mother is a 35 years old Caucasian woman with no important personal risk factors and no known history of diabetes mellitus. The glucose tolerance test performed to the mother at about 10 weeks during pregnancy led to the diagnosis of gestational diabetes. DISCUSSION: The gestational diabetes mellitus diagnosed since the 10th week of pregnancy, the hyperglycemia status during pregnancy and the fetal overgrowth (macrosomia at birth) indicate the possible factors that lead to the Orofacial cleft (OFC). CONCLUSION: With the increased prevalence of obesity, diabetes, and the evidence of association of these syndromes with OFCs, it is recommended that mothers planning to become pregnant to follow healthy habits, maintain healthy weight, and be screened for possible diabetes prior to conception and early in pregnancy.
BACKGROUND: Several studies observed metabolic disorders in pregnancy as risk factors for birth defects, including orofacial clefts. Diabetes is associated with approx. 10% of the pregnancies, but in Romania, less than 5%. An obese and diabetic woman has 3 times more risk for an offspring with a craniofacial defect than healthy women suggesting that diabetes mellitus contributes to their pathogenesis with complex mechanisms. CASE REPORT: We present the case of a newborn 4 days old, male with neonatal hypoglycemia, cleft lip and proportionate (symmetric) macrosomia. His mother is a 35 years old Caucasian woman with no important personal risk factors and no known history of diabetes mellitus. The glucose tolerance test performed to the mother at about 10 weeks during pregnancy led to the diagnosis of gestational diabetes. DISCUSSION: The gestational diabetes mellitus diagnosed since the 10th week of pregnancy, the hyperglycemia status during pregnancy and the fetal overgrowth (macrosomia at birth) indicate the possible factors that lead to the Orofacial cleft (OFC). CONCLUSION: With the increased prevalence of obesity, diabetes, and the evidence of association of these syndromes with OFCs, it is recommended that mothers planning to become pregnant to follow healthy habits, maintain healthy weight, and be screened for possible diabetes prior to conception and early in pregnancy.
Authors: A García-Patterson; L Erdozain; G Ginovart; J M Adelantado; J M Cubero; G Gallo; A de Leiva; R Corcoy Journal: Diabetologia Date: 2004-02-10 Impact factor: 10.122