Diabetic pregnancy: A literature review of maternal and neonatal adverse outcomes.

Abstract

Of all pregnant women in the United States an average of 1.5% reported to have type 1 or type 2 diabetes mellitus. Our review article will discuss and explore the relationship between pre-pregnancy diabetes and its adverse outcomes in mothers and neonates. Diabetes in pregnancy can cause a myriad of complications, many of which are related to microvascular changes, including diabetic nephropathy and retinopathy associated with preterm delivery, cesarean sections, and intrauterine growth restriction. Pregnant patients with diabetes also have an increased risk of pre-eclampsia, likely due to complications related to abnormal structure and function of the placenta. In addition, cardiovascular complications are more common and may present antepartum, intrapartum, or postpartum. Adverse neonatal outcomes that have been observed in diabetic pregnancies include fetal stillbirth and perinatal death, macrosomia, congenital malformations, respiratory distress, and neurological impairments. These complications explain the increased morbidity and mortality rate of infants of diabetic mothers, and the increased frequency of neonatal intensive care unit hospitalizations after birth. Diabetes in pregnancy causes a spectrum of changes in the maternal-fetal interface. This review addresses the placental changes during pregnancy and its adverse maternal and neonatal outcomes. We strongly believe the material discussed in this article can help in understanding the effects of diabetes during pregnancy which will ultimately aid in designing interventions to prevent these adverse outcomes.