title: Outcomes of offspring born to mothers with gestational diabetes.
abstract: With the global explosion of Diabetes and obesity at epidemic proportions, keeping Asia at its epicenter, 1 in 7 live births get complicated with hyperglycaemia; either pre-existing Diabetes or Gestational Diabetes. In utero, exposure to an adverse metabolic environment with nutrient excess or deficiencies and toxic metabolites with teratogenic potential, leads to short and long term consequences to the offspring. Multisystemic congenital malformations, macrosomia associated obstetric complications and perinatal metabolic derangements complicate the early neonatal stage. Epigenetic changes taking place during foetal development initiate foetal metabolic programming and create adverse metabolic memory leading to childhood obesity, metabolic syndrome and Diabetes. Hyperglycaemia and poor metabolic parameters throughout pregnancy correlate with adverse offspring outcomes. Novel management strategies targeting near normoglycaemia have achieved marked improvements in rates of perinatal mortality and other adverse outcomes. Therapies for management of Diabetes in pregnancy should be carefully selected upon the safety profile for the offspring.
authors: Diabetes and Endocrine Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.
authors: Noel Pratheepan
authors: NP
authors: Somasundaram
authors: Diabetes and Endocrine Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.
authors: Chandrika Jayakanthi
authors: CJ
authors: Subasinghe
authors: Diabetes and Endocrine Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.
authors: Wickrama Kankanamge
authors: WK
authors: Maheshi Gimhani Amarawardena
mesh_terms: D000015:Abnormalities, Multiple / Q000209:etiology; D001208:Asia; D016640:Diabetes, Gestational; D005260:Female; D005320:Fetal Macrosomia; D006801:Humans; D024821:Metabolic Syndrome; D009035:Mothers; D009765:Obesity; D011247:Pregnancy
keywords: Diabetes, Gestational DM, Pregnancy, Offspring, obesity.