Risk of Birth Defects with Uncontrolled Diabetes

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Diabetes before being pregnant is a risk factor for defects of the cardiovascular, central nervous and musculoskeletal system for the newborn. Even though the understanding between diabetes and birth defects during pregnancy is not well understood, there is evidence that high glycemic levels are a factor in the development of congenital malformations of the newborn. Women who are pregnant and have had normal glycemic levels before becoming pregnant have been shown to have a risk for a newborn being born with a congenital defect that is the same as the general population [1].

The development of diabetes while being pregnant has also been shown to put a fetus at risk for birth defects of the cardiovascular, central nervous and musculoskeletal system. Some of the specific defects that newborns could have include central nervous system defects, limb deficiencies, renal agenesis, hypospadias, orofacial clefts, and heart defects [1].

Recent research has indicated that there is a likelihood that diabetes can impact the pathways for cellular communication and the uptake of a cellular signal that leads to the cell performing specific functions (known as signal transduction). There is also evidence that diabetes can cause neural tube defects because the high glycemic levels in the mother increases oxidative stress in the fetus and that the oxidative stress results in the inhibition of the Pax3 gene and depresses the expression of the p53 gene. When the Pax3-p53 pathway is not working correctly, the neural crest may not develop normally. Therefore, neural tube defects can arise [1].

Prenatal screening is recommended for women who have a history of above average weight before pregnancy. The prenatal screening can detect for malformations with ultrasound scans and fetal echocardiogram[1].

These research findings show that birth defects can arise among infants who are born from mothers who have diabetes before and during pregnancy and who don’t have normal A1C levels [1]. Therefore, knowing what your blood glucose and A1C levels are before you become pregnant can help with having a healthy pregnancy for yourself and the baby [2]. To learn how to control your blood sugar levels before becoming pregnant, it is important to consult with a physician and a diabetes team if you have access to one. Communicating with health care professionals, you can learn what diet is right for you (if there is any need for changing your diet), how often to take insulin shots, how often to test your glucose levels, what vitamins you can take, and other exams (kidney and eye) that would be of benefit [2].


[1] Adolfo Correa, et al. 2008. Diabetes Mellitus and birth defects. AJOG 199-237;e1237.e9

[2] National Center for Chronic Disease Prevention and Health Promotion. 2005. Take Charge of Your Diabetes. https://www.cdc.gov/DIABETES/pubs/tcyd/pregnant.htm

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[3] {subscription required} Steven V. Edelman. 2008. Managing type 1 diabetes for pregnancy. Insulin (3)3: 199-2000.