Diabetes mellitus during pregnancy — complications for the fetus and newborn

Abstract

Currently, diabetes mellitus is considered one of the most common problems in obstetrics and neonatology, associated with its high incidence and complications it causes — perinatal loss and morbidity of newborns, as well as further negative consequences for the child’s health. The incidence of diabetes mellitus is increasing in the world every year. According to forecasts of the International Diabetes Federation, there is no tendency to decrease the incidence in the near future. The increase in the incidence of diabetes mellitus is also due to a change in the criteria for diagnosis set out in the Gestational Diabetes Mellitus Treatment Guidelines. In addition, patients often do not understand the seriousness of the complications that occur with the disease, thereby not following the doctor’s treatment recommendations. To date, it has been proven that diabetes mellitus is a main cause of perinatal morbidity and mortality. According to the World Health Organization, even slight hyperglycemia in the mother during pregnancy is associated with the development of diabetic fetopathy. This article provides an analytical review of current literature covering the issues of perinatal and neonatal outcomes in the presence of diabetic fetopathy. Its characteristic phenotypic signs include macrosomia (due to increased fat deposition in subcutaneous tissue associated with increased production of somatotropic hormone) or microsomia (due to primary placental insufficiency), general pastiness, skin hyperemia, characteristic сushingoid-type appearance, body disproportion, puffy face in combination with other signs of immaturity, as well as transient hypertrophic cardiomyopathy and hepatosplenomegaly.