ETIOLOGICAL, BIOCHEMICAL, AND PATHOPHYSIOLOGICAL CHANGES DURING GESTATIONAL DIABETES LEADING TO NEURAL TUBE DEFECTS IN FOETUSES – A REVIEW
Journal Title: World Journal of Pharmaceutical and life sciences - Year 2017, Vol 3, Issue 8
Abstract
Background Among the several risk factors, maternal diabetes mellitus during pregnancy is considered as an important risk factor for the incidences of neural tube defects (NTDs). The prevalence of hyperglycaemia in pregnant women was 16.9% affecting ~21 million live births globally (2013- report). Further the scope of NTDs in these women was reported to be ten times higher than in non-diabetic pregnant women. Hence the objective of this article is to elucidate a comprehensive review on the biochemical, cellular and molecular mechanisms involved in causation of NTDs in hyperglycaemic environment during pregnancy. Key Findings It was observed that maternal hyperglycaemia is a marker for metabolic abnormalities which results in enhanced polyol pathway; inositol depletion; altered arachidonic acid metabolism and formation of advanced glycation end products. These underlying metabolic abnormalities in gestational diabetic women affects various signaling molecules, transcription factors that regulate neurulation processes, cell proliferation and differentiation of neural stem cells in the developing fetus leading to the development of NTDs. Details of these mechanisms and how they are interlinked with gestational diabetes is described in this article. Conclusion This review summarizes the possible biochemical mechanisms involved in aetiology of hyperglycaemia induced NTDs. Having reviewed the scenario of the probable causes of NTDs, it is concluded that there is an imperative need for identifying novel diagnostic markers for early detection of NTDs thus offering hope to gestational diabetic women to deliver a child free from NTDs. Some of the probable biomarkers are being highlighted through this investigation.
Authors and Affiliations
Vinitha Edula
Keywords
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