Impact of gestational hyperglycemia on maternal and child health.
OBJECTIVE
To address the recent evidence regarding the association between hyperglycemia during pregnancy and adverse short-term and long-term outcome for both mothers and offspring.


RESULTS
Recent data suggest a relationship between hyperglycemia during pregnancy and adverse short-term fetal outcomes, mainly those associated with excessive fetal growth. The degree of hyperglycemia plays an important role in risk stratification. Moreover, the long-term effect of hyperglycemia during pregnancy is expressed mainly as cardiometabolic morbidity and increased risk for the development of metabolic syndrome both maternal and in early adolescence. Alternation in DNA methylation and gene expression of metabolic pathways were found in association with hyperglycemia in utero, supporting the 'developmental origins of disease' hypothesis.


CONCLUSIONS
The effect of hyperglycemia on the early life metabolic environment may contribute to the subsequent risk of cardiovascular or metabolic morbidity later in life. It is also a sign of future maternal metabolic alternation. Several future randomized trials, hopefully will help to determine if early intervention could decrease the risk for gestational diabetes and whether long term adverse outcome are preventable and importantly the association with degree of maternal hyperglycemia in pregnancy and future morbidity.
Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Liran
L
Hiersch
Yariv
Y
Yogev
D002318:Cardiovascular Diseases; D016640:Diabetes, Gestational / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D047109:Fetal Development; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D024821:Metabolic Syndrome; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011297:Prenatal Exposure Delayed Effects