Article Sections

Introduction

Infants of diabetic mothers (IDM) are those born to mothers with diabetes, whether gestational diabetes mellitus (GDM) or preexisting diabetes (type 1 or type 2).  Maternal hyperglycemia disrupts the metabolic environment of fetal development and leads to significant complications ( Table 1), which vary according to the gestational age when the fetus is exposed to the elevated blood sugars.  IDMs are also subject to a unique set of conditions following delivery that primarily stem from elevated maternal blood glucose levels ( Figure 1).

First trimester complications

Maternal hyperglycemia early in pregnancy is most likely related to pregestational diabetes (either type 1 or type 2 diabetes mellitus [DM]), and leads to diabetic embryopathy.  The most common consequence of uncontrolled blood glucose levels in early pregnancy is spontaneous abortions (risk directly related to increasing hemoglobin A1c).  For fetuses that continue through fetal embryogenesis, there is a large risk of birth defects in every organ system, particularly the cardiovascular and central nervous system.

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Figures

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Tables

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