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The Challenges of Treating Glucokinase MODY during Pregnancy: A Review of Maternal and Fetal Outcomes

Background: The optimal treatment strategy for the follow-up and management of women with glucokinase maturity-onset diabetes of the young (GCK−MODY)during pregnancy remains unknown. Data regarding maternal and fetal outcomes are lacking. Aim: This paper summarizes the existing literature regarding...

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Autores principales: Kirzhner, Alena, Barak, Oren, Vaisbuch, Edi, Zornitzki, Taiba, Schiller, Tal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9141824/
https://www.ncbi.nlm.nih.gov/pubmed/35627517
http://dx.doi.org/10.3390/ijerph19105980
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author Kirzhner, Alena
Barak, Oren
Vaisbuch, Edi
Zornitzki, Taiba
Schiller, Tal
author_facet Kirzhner, Alena
Barak, Oren
Vaisbuch, Edi
Zornitzki, Taiba
Schiller, Tal
author_sort Kirzhner, Alena
collection PubMed
description Background: The optimal treatment strategy for the follow-up and management of women with glucokinase maturity-onset diabetes of the young (GCK−MODY)during pregnancy remains unknown. Data regarding maternal and fetal outcomes are lacking. Aim: This paper summarizes the existing literature regarding the maternal and fetal outcomes of women with glucokinase MODY to guide future treatment strategy. Methods: A literature search was conducted in Pubmed, Embace, and Cochrane library with citation follow-up using the terms: glucokinase, MODY, diabetes, pregnancy, gestation, and outcomes. We searched for articles with known fetal mutational status. Relevant outcomes included: birthweight, large for gestational age (LGA), small for gestational age (SGA), macrosomia, cesarean delivery (CD), shoulder dystocia, congenital anomalies, miscarriages, preterm births, and long-term outcomes. Results: Fourteen relevant manuscripts were identified describing maternal and fetal outcomes. The percentage of LGA and macrosomia in 102 glucokinase -unaffected offspring (GCK−) was significantly higher than in the glucokinase -affected offspring (GCK+) (44% vs. 10%, p < 0.001 and 22% vs. 2%, p < 0.001, respectively). Among the 173 GCK(+) offspring, only 5% were SGA, which can be expected according to the normal distribution. We observed higher rates of CD and shoulder dystocia in the GCK(−) offspring. Conclusions: GCK(−) offspring have significantly higher birthweights and more birth complications. The optimal treatment strategy to guide management should take into consideration multiple variables other than fetal mutational status.
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spelling pubmed-91418242022-05-28 The Challenges of Treating Glucokinase MODY during Pregnancy: A Review of Maternal and Fetal Outcomes Kirzhner, Alena Barak, Oren Vaisbuch, Edi Zornitzki, Taiba Schiller, Tal Int J Environ Res Public Health Review Background: The optimal treatment strategy for the follow-up and management of women with glucokinase maturity-onset diabetes of the young (GCK−MODY)during pregnancy remains unknown. Data regarding maternal and fetal outcomes are lacking. Aim: This paper summarizes the existing literature regarding the maternal and fetal outcomes of women with glucokinase MODY to guide future treatment strategy. Methods: A literature search was conducted in Pubmed, Embace, and Cochrane library with citation follow-up using the terms: glucokinase, MODY, diabetes, pregnancy, gestation, and outcomes. We searched for articles with known fetal mutational status. Relevant outcomes included: birthweight, large for gestational age (LGA), small for gestational age (SGA), macrosomia, cesarean delivery (CD), shoulder dystocia, congenital anomalies, miscarriages, preterm births, and long-term outcomes. Results: Fourteen relevant manuscripts were identified describing maternal and fetal outcomes. The percentage of LGA and macrosomia in 102 glucokinase -unaffected offspring (GCK−) was significantly higher than in the glucokinase -affected offspring (GCK+) (44% vs. 10%, p < 0.001 and 22% vs. 2%, p < 0.001, respectively). Among the 173 GCK(+) offspring, only 5% were SGA, which can be expected according to the normal distribution. We observed higher rates of CD and shoulder dystocia in the GCK(−) offspring. Conclusions: GCK(−) offspring have significantly higher birthweights and more birth complications. The optimal treatment strategy to guide management should take into consideration multiple variables other than fetal mutational status. MDPI 2022-05-14 /pmc/articles/PMC9141824/ /pubmed/35627517 http://dx.doi.org/10.3390/ijerph19105980 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Kirzhner, Alena
Barak, Oren
Vaisbuch, Edi
Zornitzki, Taiba
Schiller, Tal
The Challenges of Treating Glucokinase MODY during Pregnancy: A Review of Maternal and Fetal Outcomes
title The Challenges of Treating Glucokinase MODY during Pregnancy: A Review of Maternal and Fetal Outcomes
title_full The Challenges of Treating Glucokinase MODY during Pregnancy: A Review of Maternal and Fetal Outcomes
title_fullStr The Challenges of Treating Glucokinase MODY during Pregnancy: A Review of Maternal and Fetal Outcomes
title_full_unstemmed The Challenges of Treating Glucokinase MODY during Pregnancy: A Review of Maternal and Fetal Outcomes
title_short The Challenges of Treating Glucokinase MODY during Pregnancy: A Review of Maternal and Fetal Outcomes
title_sort challenges of treating glucokinase mody during pregnancy: a review of maternal and fetal outcomes
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9141824/
https://www.ncbi.nlm.nih.gov/pubmed/35627517
http://dx.doi.org/10.3390/ijerph19105980
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