title: Diabetes-induced birth defects: what do we know? What can we do?
abstract: Birth defects are the leading cause of infant mortality in the United States, which has one of the highest infant mortality rates in the developed world. Many of these birth defects can be attributed to pre-existing, or pregestational, diabetes in pregnancy, which significantly increases a mother's risk of having a child with a major birth defect. Strict preconceptional and early pregnancy glucose control, supplementation with multivitamins and fatty acids, and lower glycemic dietary management have been shown to reduce the incidence of birth defects in experimental and epidemiologic studies. However, because more than half of pregnancies are unplanned, these methods are not generalizable across the population. Thus, better interventions are urgently needed. Based on what we know about the molecular pathophysiology of diabetic embryopathy, our laboratory and others are developing interventions against to key molecular targets in this multifactorial disease process.
authors.affiliation: University of Maryland School of Medicine, 655 West Baltimore Street, Room 14-029, Baltimore, MD 21201-1559, USA. deanmed@som.umaryland.edu
authors.forename: E Albert
authors.initials: EA
authors.lastname: Reece
mesh_terms: D000013:Congenital Abnormalities / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D016640:Diabetes, Gestational / Q000453:epidemiology*; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D006801:Humans; D008403:Mass Screening; D009436:Neural Tube Defects / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D009765:Obesity / Q000150:complications* / Q000378:metabolism; D016742:Preconception Care; D011236:Prediabetic State / Q000378:metabolism / Q000503:physiopathology*; D011247:Pregnancy; D014481:United States / Q000453:epidemiology
chemical_list: D005492:Folic Acid