Zhang Meihua, Ma Munan, Wang Jinping, Wang Yijun, Yang Xinrui, Fu Songtao
Maternity Department, Taiyuan Maternal and Child Health Hospital, Taiyuan, Shanxi 030001, China.
Department of Biochemistry & Molecular Biology, Shanxi Medical University, Taiyuan, Shanxi 030001, China.
Matern Fetal Med. 2021 Sep 23;5(1):31-35. doi: 10.1097/FM9.0000000000000130. eCollection 2023 Jan.
The effects of gestational diabetes mellitus (GDM) on offspring include macrosomia, hypoglycemia, respiratory distress syndrome, cardiovascular disease, neural and mental injury, etc. The effects of GDM on the health status of offspring are sustained although pregnancy has ended. It has been proposed that fetal reprogramming causes long-term consequences to metabolic health in offspring. An intrauterine high-glucose environment may lead to changes in the multi-differentiation proficiency of intracorporal stem cells, showing decreased proliferation and osteogenic ability, increased adipogenic ability, accelerated apoptosis, and occurrence of premature failure. This environment also reduces the mobilization of bone marrow stem cells, whereas it increases that of medullary cells. This results in pro-inflammatory conditions and sustained inflammation in the body, thereby increasing the risk of obesity, cardiovascular and neurological disorders, and metabolic abnormalities. Stem cells derived from the amniotic membrane, umbilical cord, or placenta may be a reliable predictor of the long-term effects of GDM on offspring. The levels of blood glucose during pregnancy should be effectively controlled to reduce harm to the neonate.
妊娠期糖尿病(GDM)对后代的影响包括巨大儿、低血糖、呼吸窘迫综合征、心血管疾病、神经和精神损伤等。尽管妊娠已经结束,但GDM对后代健康状况的影响仍然存在。有人提出,胎儿重编程会给后代的代谢健康带来长期后果。子宫内的高糖环境可能导致体内干细胞多分化能力发生变化,表现为增殖和成骨能力下降、脂肪生成能力增加、细胞凋亡加速以及过早衰竭的发生。这种环境还会减少骨髓干细胞的动员,而增加髓细胞的动员。这会导致体内出现促炎状态和持续性炎症,从而增加肥胖、心血管和神经疾病以及代谢异常的风险。来自羊膜、脐带或胎盘的干细胞可能是GDM对后代长期影响的可靠预测指标。孕期应有效控制血糖水平,以减少对新生儿的伤害。