Diabetes in Pregnancy and Lung Health in Offspring: Developmental Origins of Respiratory Disease

Paediatr Respir Rev. 2017 Jan;21:19-26. doi: 10.1016/j.prrv.2016.08.007. Epub 2016 Aug 19.

Abstract

Diabetes is an increasingly common complication of pregnancy. In parallel with this trend, a rise in chronic lung disease in children has been observed in recent decades. While several adverse health outcomes associated with exposure to diabetes in utero have been documented in epidemiological and experimental studies, few have examined the impact of diabetes in pregnancy on offspring lung health and respiratory disease. We provide a comprehensive overview of current literature on this topic, finding suggestive evidence that exposure to diabetes in utero may have adverse effects on lung development. Delayed lung maturation and increased risk of respiratory distress syndrome have been consistently observed among infants born to mothers with diabetes and these findings are also observed in some rodent models of diabetes in pregnancy. Further research is needed to confirm and characterize epidemiologic observations that diabetes in pregnancy may predispose offspring to childhood wheezing illness and asthma. Parallel translational studies in human pregnancy cohorts and experimental models are needed to explore the role of fetal programming and other potential biological mechanisms in this context.

Keywords: asthma; chronic lung disease; developmental origins of health and disease; gestational diabetes; lung development; maternal diabetes; pregnancy; respiratory distress syndrome.

Publication types

  • Review

MeSH terms

  • Animals
  • Asthma / epidemiology
  • Asthma / metabolism
  • Bronchopulmonary Dysplasia / epidemiology
  • Bronchopulmonary Dysplasia / metabolism
  • Child
  • Diabetes, Gestational / epidemiology*
  • Diabetes, Gestational / metabolism
  • Disease Models, Animal
  • Female
  • Hernias, Diaphragmatic, Congenital / epidemiology
  • Hernias, Diaphragmatic, Congenital / metabolism
  • Humans
  • Infant, Newborn
  • Lung / embryology*
  • Pregnancy
  • Pregnancy in Diabetics / epidemiology*
  • Pregnancy in Diabetics / metabolism
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Prenatal Exposure Delayed Effects / metabolism
  • Respiratory Distress Syndrome, Newborn / epidemiology
  • Respiratory Distress Syndrome, Newborn / metabolism
  • Respiratory Sounds
  • Respiratory Tract Diseases / epidemiology*
  • Respiratory Tract Diseases / metabolism