ABSTRACT
The association between maternal diabetes mellitus and congenital malformations in newborns may well be causal; however, the teratogenic mechanism remains unclear. The prevalence and the described type of malformations vary among different studies, and a predictable malformation syndrome has not been identified. The chapter discusses the prevalence and types of structural congenital malformations in infants of mothers with diabetes mellitus (IDM) or gestational diabetes mellitus (IGDM). The congenital malformations of IDM and IGDM constitute a spectrum known as diabetic embryopathy. This spectrum implies errors of morphogenesis that appear between the third and the seventh week of embryonic development. Cardiac malformations are the most common congenital malformations of IDM, and they occur significantly more often in IDM than in infants of nondiabetic mothers. Maternal diabetes mellitus and gestational diabetes with fasting hyperglycemia are associated with a twofold to threefold increase in the risk of congenital malformations in offspring compared with the general population.
