Chen Zhi-Yan, Mao Shuang-Fa, Guo Ling-Hong, Qin Jian, Yang Li-Xin, Liu Yin
Department of Basic Medical Sciences, Sichuan Vocational College of Health and Rehabilitation, Zigong, 643000, China.
Department of Pharmacology, West China School of Basic Sciences and Forensic Medicine, Sichuan University, Chengdu, 610041, China.
World J Pediatr. 2023 Apr;19(4):303-314. doi: 10.1007/s12519-022-00582-w. Epub 2022 Jul 15.
The increasing population of diabetes mellitus in adolescent girls and women of childbearing age contributes to a large number of pregnancies with maternal pregestational diabetes mellitus. Congenital heart diseases are a common adverse outcome in mothers with pregestational diabetes mellitus. However, there is little systematic information between maternal pregestational diabetes mellitus and congenital heart diseases in the offspring.
Literature selection was performed in PubMed. One hundred and seven papers were cited in our review, including 36 clinical studies, 26 experimental studies, 31 reviews, eight meta-analysis articles, and six of other types.
Maternal pregestational diabetes mellitus poses a high risk of congenital heart diseases in the offspring and causes variety of phenotypes of congenital heart diseases. Factors such as persistent maternal hyperglycemia, oxidative stress, polymorphism of uncoupling protein 2, polymorphism of adiponectin gene, Notch 1 pathway, Nkx2.5 disorders, dysregulation of the hypoxia-inducible factor 1, and viral etiologies are associated with the occurrence of congenital heart diseases in the offspring of mothers with pregestational diabetes mellitus. Treatment options including blood sugar-reducing, anti-oxidative stress drug supplements and exercise can help to prevent maternal pregestational diabetes mellitus from inducing congenital heart diseases.
Our review contributes to a better understanding of the association between maternal pregestational diabetes mellitus and congenital heart diseases in the offspring and to a profound thought of the mechanism, preventive and therapeutic measurements of congenital heart diseases caused by maternal pregestational diabetes mellitus.
青春期女孩和育龄妇女中糖尿病患者数量不断增加，导致大量妊娠合并孕前糖尿病。先天性心脏病是孕前糖尿病母亲常见的不良结局。然而，关于孕前糖尿病母亲与后代先天性心脏病之间的系统性信息较少。
在PubMed中进行文献筛选。我们的综述引用了107篇论文，包括36项临床研究、26项实验研究、31篇综述、8篇荟萃分析文章和6篇其他类型的文章。
孕前糖尿病母亲使后代患先天性心脏病的风险很高，并导致多种先天性心脏病表型。母体持续性高血糖、氧化应激、解偶联蛋白2多态性、脂联素基因多态性、Notch 1信号通路、Nkx2.5紊乱、缺氧诱导因子1失调以及病毒病因等因素与孕前糖尿病母亲后代先天性心脏病的发生有关。包括降糖、补充抗氧化应激药物和运动在内的治疗选择有助于预防孕前糖尿病母亲诱发先天性心脏病。
我们的综述有助于更好地理解孕前糖尿病母亲与后代先天性心脏病之间的关联，并促使人们深入思考孕前糖尿病母亲所致先天性心脏病的发病机制、预防和治疗措施。
