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World J Diabetes. Apr 15, 2015; 6(3): 481-488
Published online Apr 15, 2015. doi: 10.4239/wjd.v6.i3.481
Birth defects in pregestational diabetes: Defect range, glycemic threshold and pathogenesis
Rinat Gabbay-Benziv, E Albert Reece, Fang Wang, Peixin Yang
Rinat Gabbay-Benziv, E Albert Reece, Fang Wang, Peixin Yang, Department of Obstetrics, Gynaecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, United States
E Albert Reece, Peixin Yang, Department of Biochemistry and Molecular Biology, University of Maryland School of Medicine, Baltimore, MD 21201, United States
Author contributions: Gabbay-Benziv R and Wang F collected the data and wrote the manuscript; Reece EA contributed to the writing of the manuscript; Yang P designed the aim of the editorial and wrote the manuscript; all authors reviewed the manuscript, made their revision and finally approved it for publication.
Conflict-of-interest: None of the authors have a conflict of interest.
Supported by NIH R01DK083243, R01DK101972 and R56 DK095380 (to Yang P), R01DK103024 (to Yang P and Reece EA) and Basic Science Award (1-13-BS-220), American Diabetes Association (to Yang P).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Peixin Yang, PhD, Department of Obstetrics, Gynaecology and Reproductive Sciences, University of Maryland School of Medicine, BRB11-039, 655 W. Baltimore Street, Baltimore, MD 21201, United States. pyang@fpi.umaryland.edu
Telephone: +1-410-7068402 Fax: +1-410-7065747
Received: August 29, 2014
Peer-review started: August 30, 2014
First decision: November 27, 2014
Revised: December 9, 2014
Accepted: January 9, 2015
Article in press: January 12, 2015
Published online: April 15, 2015
Core Tip

Core tip: Pregestational diabetes is a rising problem with gravid impact on adverse pregnancy outcomes. This review concentrates on diabetes-induced birth defects and the underlying mechanism of diabetic embryopathy derived from animal studies. The main defects associated with pregestational diabetes are in the cardiovascular and central nervous systems, and are linearly related to maternal glycemic control. Animal studies reveal oxidative stress and stress kinase signalling-induced apoptosis as key factors in pathogenesis. However, many questions remain unanswered, and the rate of congenital defects in human diabetic pregnancies is still high. The cause of diabetic embryopathy warrants further investigations.