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Impact of gestational hyperglycemia on maternal and child health

Hiersch, Liran; Yogev, Yariv

Current Opinion in Clinical Nutrition & Metabolic Care: May 2014 - Volume 17 - Issue 3 - p 255–260
doi: 10.1097/MCO.0000000000000030
PAEDIATRICS: Edited by Berthold V. Koletzko and Raanan Shamir

Purpose of review 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.

Recent findings 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.

Summary 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

Correspondence to Yariv Yogev, MD, Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tiqwa 49100, Israel. Tel: +972 3 9377400; fax: +972 3 9377409; e-mail: yarivyogev@hotmail.com

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