The pathogenesis of diabetes-associated congenital malformations

Obstetrics and Gynecology Clinics of North America

Volumn 23, Issue 1, 1996, Pages 29-45

  Reece, E A ^a   Eriksson, U J ^a  

^a Department of Obstetrics ^*  (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARACHIDONIC ACID; FREE RADICAL; INOSITOL; PROSTAGLANDIN DERIVATIVE;

BIRTH DEFECT; CONGENITAL MALFORMATION; EMBRYOPATHY; HUMAN; HYPERGLYCEMIA; MATERNAL DIABETES MELLITUS; NONHUMAN; PATHOGENESIS; PREGNANCY COMPLICATION; PRIORITY JOURNAL; REVIEW; YOLK SAC;

EID: 0029966376     PISSN: 08898545     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0889-8545(05)70243-6     Document Type: Article

References (144)

1. E.Y. Adashi H. Pinto J.E. Tyson Impact of maternal euglycemia on fetal outcome in diabetic pregnancy Am J Obstet Gynecol 133 1979 268
2. M. Akashi S. Akazawa M. Akazawa Effects of insulin and myo -inositol on embryo growth and development during early organogenesis in streptozotocin-induced diabetic rats Diabetes 40 1991 1574 1579
3. S. Akazawa M. Akazawa M. Hashimoto Effects of hypoglycemia on early embryogenesis in rat embryo organ culture Diabetologia 30 1987 791 796
4. L. Baker J.M. Egler S.H. Klein Meticulous control of diabetes during organogenesis prevents congenital lumbosacral defects in rats Diabetes 30 1981 955
5. L. Baker R. Piddington A.S. Goldman Myo -inositol and prostaglandins reverse the glucose inhibition of neural tube fusion in cultured mouse embryos Diabetologia 33 1990 593 596
6. J.L. Ballard J. Holroyde R.C. Tsang High malformation rates and decreased mortality in infants of diabetic mothers managed after the first trimester of pregnancy (1956-1978) Am J Obstet Gynecol 148 1979 1111
7. R.W. Beard C. Lowrey Commentary: The British survey of diabetic pregnancies Br J Obstet Gynaecol 89 1982 783
8. J.E. Bocerra M.J. Khoury J.F. Cordero Diabetes mellitus during pregnancy and the risks for specific birth defects: A population-based case-control study Pediatrics 85 1990 1 9
9. M. Bergman T.B. Seaton C.C. Auerhahn The incidence of gestational hypoglycemia in insulin-dependent and non-insulin-dependent diabetic women NY State J Med 86 1986 174 177
10. S. Bhasin G.E. Shambaugh III Fetal fuels. V. Ketone bodies inhibit pyrimidine biosynthesis in fetal rat brain Am J Physiol 243 1982 E234 E239
11. A. Brinsmade F. Büchner H. Rübsaamen Missbildungen am Kaninchen embryo durch Insulininjektion beim Muttertier Naturwissenschaften 43 1956 259
12. A.B. Brinsmade Entwicklungsstörungen am Kaninchenembryo nach Glukosemangel beim trächtigen Muttertier Beit Path Anat 117 1957 140 153
13. T.A. Buchanan K.M. Denno G.F. Sipos Diabetic teratogenesis: In vitro evidence for a multifactorial etiology with little contribution from glucose per se Diabetes 43 1994 656 660
14. T.A. Buchanan J.K. Schemmer N. Freinkel Embryotoxic effects of brief maternal insulin-hypoglycemia during organogenesis in the rat J Clin Invest 78 1986 643 649
15. H.F. Bunn D.N. Haney S. Kamis The biosynthesis of human hemoglobin A1C: Slow glycosylation of hemoglobin in vivo J Clin Invest 57 1976 1652
16. D.L. Cockroft P.T. Coppola Teratogenic effects of excess glucose on head-fold rat embryos in culture Teratology 16 1977 141
17. L.J. Comess P.H. Bennett T.A. Burch Congenital anomalies and diabetes in the Pima Indians of Arizona Diabetes 18 1969 471
18. G. Chomette Entwicklungsstörungen nach Insulinschock beim trächtigen Kaninchen Beit Path Anat 115 1955 439 451
19. C.S. Chung N.C. Myrianthopoulos Factors affecting risks of congenital malformations. II. Effect of maternal diabetes on congenital malformations Birth Defects 11 1975 23
20. P. Damm L. Møsted-Pedersen Significant decrease in congenital malformations in newborn infants of an selected population of diabetic women Am J Obstet Gynecol 161 1989 1163 1167
21. R. De Hertogh I. Vanderheyden S. Pampfer Stimulatory and inhibitory effects of glucose and insulin on rat blastocyst development in vitro Diabetes 40 1991 641 647
22. M.P. Diamond K. Harbert-Moley J. Logan Manifestation of diabetes mellitus on mouse follicular and pre-embryo development: Effects of hyperglycemia per se Metabolism 39 1990 220 224
23. S.G. Driscoll The pathology of pregnancy complicated by diabetes mellitus Med Clin North Am 49 1965 1053
24. M.I. Drury A.T. Green J.M. Stronge Pregnancy complicated by clinical diabetes mellitus: A study of 600 pregnancies Am J Obstet Gynecol 49 1977 519
25. P.K. Duraiswami Insulin-induced skeletal abnormalities in developing chickens BMJ 2 1950 384 390
26. S.K.L. Ellington In vivo and in vitro studies on the effects of maternal fasting during embryonic organogenesis in the rat Reprod Fertil 60 1980 383 388
27. B. Engström Å. Haglund U.J. Eriksson Effects of maternal diabetes or in vitro hyperglycemia on uptake of palmitic and arachidonic acid by rat embryos Pediatr Res 30 1991 150 153
28. R.S.M. Eriksson L. Thunberg U.J. Eriksson Effects of interrupted insulin treatment on fetal outcome of pregnant diabetic rats Diabetes 38 1989 764 772
29. Eriksson UJ: Antioxidants protect rat embryos from diabetes-induced dysmorphogenesis. In Abstracts of the 15th International Diabetes Federation Congress, Ontario, Canada, 1994, No. 410
30. U.J. Eriksson Congenital malformations in diabetic animal models— a review Diabetes Res 1 1984 57
31. U.J. Eriksson Importance of genetic predisposition and maternal environment for the occurrence of congenital malformations in offspring of diabetic rats Teratology 37 1988 365 374
32. U.J. Eriksson Rat embryos exposed to a teratogenic diabetic environment in vitro are protected by the antioxidant N -acetylcysteine Eur J Endocrinol 130 suppl 1 1994 20
33. U.J. Eriksson A.J. Bone D.M. Turnbull Timed interruption of insulin therapy in diabetic BB/E rat pregnancy: Effects on maternal metabolism and fetal outcome Acta Endocrinol (Copenh) 120 1989 800 810
34. U.J. Eriksson L.A.H. Borg Diabetes and embryonic malformations: Role of substrate-induced free oxygen radical production for dysmorphogenesis in cultured rat embryos Diabetes 42 1993 411 419
35. U.J. Eriksson L.A.H. Borg Protection by free oxygen radical scavenging enzymes against glucose-induced embryonic malformations in vitro Diabetologia 34 1991 325 331
36. U.J. Eriksson L.A.H. Borg Z. Hagay Increased superoxide dismutase (SOD) activity in embryos of transgenic mice protects from the teratogenic effects of a diabetic environment Diabetes 42 suppl 1 1993 85A
37. U.J. Eriksson E. Dahlström K.S. Larsson Increased incidence of congenital malformations in the offspring of diabetic rats and their prevention by maternal insulin therapy Diabetes 31 1982 1
38. U.J. Eriksson V.E. Dahlstrom H.O. Lithell Diabetes in pregnancy: Influence of genetic background and maternal diabetic state on the incidence of skeletal malformations in the fetal rat Acta Endocrinol 277 1986 66 73
39. Eriksson UJ, den Bieman M, Prins JB, et al: Differences in susceptibility for diabetes induced malformations in separated rat colonies of common origin. In Proceedings of the 4th FELASA Symposium, Lyon, France, 1990, pp 53-57
40. U.J. Eriksson N.J. Lewis N. Freinkel Growth retardation during early organogenesis in embryos of experimentally diabetic rats Diabetes 33 1984 281
41. U.J. Eriksson P. Naeser S. Brolin Increased accumulation of sorbitol in embryos of manifest diabetic rats Diabetes 35 1986 1356 1363
42. U.J. Eriksson P. Naeser S.E. Brolin Influnce of sorbitol accumulation on growth and development of embryos cultured in elevated levels of glucose and fructose Diabetes Res 11 1989 27 32
43. N. Freinkel Banting Lecture 1980: Of pregnancy and progeny Diabetes 29 1980 1023
44. N. Freinkel Fuel mediated teratogenesis: Diabetes in pregnancy as paradigm for evaluating the developmental impact of maternal fuels M. Serrano-Rios P.J. Lefebvre Diabetes 1985 Elsevier Science Publishers New York 563
45. N. Freinkel Metabolic implications of mild disturbances in maternal carbohydrate intolerance Diabetes Care 3 1980 399
46. N. Freinkel B.E. Metzger Pregnancy as a tissue culture experience: The critical implications of maternal metabolism for fetal development Pregnancy, Metabolism, Diabetes and the Fetus, Ciba Foundation Series 63 1979 Excerpta Medica Amsterdam
47. N. Freinkel B.E. Metzger R.L. Phelps Gestational diabetes mellitus: Heterogeneity of maternal age, weight, insulin secretion, HLA antigens, and islet cell antibodies and the impact of maternal metabolism on pancreatic β-cell and somatic development in the offspring Diabetes 34 1985 1
48. K. Fuhrmann H. Reiher K. Semmler Prevention of congenital malformations in infants of insulin-dependent diabetic mothers Diabetes Care 6 1983 219
49. K. Funaki K. Mikamo Developmental-stage-dependent teratogenic effects of maternal spontaneous diabetes in the Chinese hamster Diabetes 32 1983 738
50. S.G. Gabbe Congenital malformations in infants of diabetic mothers Obstet Gynecol Surv 32 1977 125
51. S.G. Gabbe J.H. Mestman R.K. Freeman Management and outcome of pregnancy in diabetes mellitus: Classes B to R Am J Obstet Gynecol 129 1977 723
52. E.A. Garnham F. Beck C.A. Clarke Effects of glucose on rat embryos in culture Diabetologia 25 1983 291 295
53. A. Goldman D. Dicker D. Feldberg Pregnancy outcome in patients with insulin-dependent diabetes mellitus with preconceptional diabetic control: A comparative study Am J Obstet Gynecol 155 1986 293
54. A.S. Goldman L. Baker R. Piddington Hyperglycemia-induced teratogenesis is mediated by a functional deficiency of arachidonic acid Proc Natl Acad Sci USA 82 1985 8227 8231
55. 2 prevents anomalies induced by hyperglycemia or diabetic serum in mouse embryos Diabetes 41 1992 1644 1650
56. 1 and risk for major malformation and spontaneous abortion in diabetic pregnancy Teratology 39 1989 225 231
57. D.R. Hadden Diabetes in pregnancy, 1985: Clinical controversy Diabetologia 29 1986 1
58. Z. Hagay Y. Weiss I. Zusman Prevention of diabetic embryopathy by overexpression of the free radical scavenging enzyme, superoxide dismutase, in transgenic mouse embryoes Am J Obstet Gynecol 122 1995 254
59. R.S. Hannah K.L. Moore Effects of fasting and insulin on skeletal development in rats Teratology 4 1971 135 140
60. 1c in early type 1 (insulin-dependent) diabetic pregnancy and the occurrence of spontaneous abortion and fetal malformation in Sweden Diabetologia 33 1990 100 104
61. M. Hashimoto S. Akazawa M. Akazawa Effects of hyperglycemia on sorbitol and myo -inositol contents of cultured embryos: Treatment with aldose reductase inhibitor and myo -inositol supplementation Diabetologia 33 1990 597 602
62. M. Hod S. Star J. Passoneau Effect of hyperglycemia on sorbitol and myo -inositol content of cultured rat conceptus: Failure of aldose reductase inhibitors to modify myo -inositol depletion and dysmorphogenesis Biochem Biophys Res Commun 140 1986 974 980
63. M. Hod S. Star J.V. Passonneau Glucose-induced dysmorphogenesis in the cultured rat conceptus: Prevention by supplementation with myo -inositol Isr J Med Sci 26 1990 541 544
64. W.E. Horton T.W. Sadler E.S. Hunter Effects of hyperketonemia on mouse embryonic and fetal glucose metabolism in vitro Teratology 31 1985 227 233
65. W.E. Horton Jr T.W. Sadler Effects of maternal diabetes on early embryogenesis: Alteration in morphogenesis produced by the ketone body, beta-hydroxybutyrate Diabetes 32 1983 610 616
66. E.S. Hunter T.W. Sadler R.E. Wynn A potential mechanism of DL β-hydroxybutyrate induced malformations in mouse embryos Am J Physiol 253 1987 E72 E80
67. D.J. Impastato A.R. Gabriel E.H. Lardar Electric and insulin shock therapy during pregnancy Dis Nerv Syst 25 1964 542 546
68. H. Kalter J. Warkany Congenital malformations N Engl J Med 308 1983 491
69. H. Kalter J. Warkany Congenital malformations: Etiologic factors and their role in prevention N Engl J Med 308 1983 424
70. K. Karlsson I. Kjellmer The outcome of diabetic pregnancies in relation to the mother's blood sugar level Am J Obstet Gynecol 112 1972 213
71. S. Kathan R. Schwartz P. Adam Placental barrier to human insulin 1125 in insulin-dependent diabetic mothers J Clin Endocrinol Metab 40 1975 139
72. Khandelwal M, Wu YK, Borenstein M, et al: Dietary phospholipid therapy, hyperglycemia-induced membrane changes and associated diabetic embryopathy. Am J Obstet Gynecol, submitted
73. R. Kimmerle L. Heinemann A. Delecki Severe hypoglycemia incidence and predisposing factors in 85 pregnancies of type I diabetic women Diabetes Care 15 1992 1034 1037
74. J.L. Kitzmiller J.P. Cloherty M.D. Younger Diabetic pregnancy and perinatal morbidity Am J Obstet Gynecol 131 1978 560
75. J.L. Kitzmiller L.A. Gavin G.D. Gin Preconception care of diabetes: Glycemic control prevents congenital anomalies JAMA 265 1991 731 736
76. J. Kucera Rate and type of congenital anomalies among offspring of diabetic women J Reprod Med 7 1971 61
77. W. Landauer Rumplessness of chicken embryos produced by the injection of insulin in other chemicals J Exp Zool 98 1945 65
78. E. LeCorche Du Diabetic dans ses rapports avec la vie uterine menstruation et al grusesse Annales de Gynecologic 24 1885 257
79. 1 in diabetic pregnancy Lancet 2 1978 958
80. M.E. Levin L.A. Rigg R.E. Marshall Pregnancy and diabetes Arch Intern Med 146 1986 758
81. N.J. Lewis S. Akazawa N. Freinkel Teratogenesis from beta-hydroxybutyrate during organogenesis in rat embryo organ culture and enhancement by subteratogenic glucose Diabetes 32 suppl 1 1983 11A
82. H. Lichtenstein G.M. Guest J. Warkanay Abnormalities in offspring of white rats given protamine zinc insulin during pregnancy Proc Soc Exp Biol Med 78 1951 398 402
83. E.J. Love R.A.H. Kinch J.A.F. Stevenson The effect of protamine zinc insulin on the outcome of pregnancy in the normal rat Diabetes 13 1964 44 48
84. 1c in early pregnancy and major congenital anomalies in infants of diabetic mothers N Engl J Med 304 1981 1331
85. J.L. Mills Malformations in infants of diabetic mothers Teratology 25 1982 385
86. J.L. Mills L. Baker A.S. Goldman Malformations in infants of diabetic mothers occur before the seventh gestational week: Implications for treatment Diabetes 28 1979 292
87. J.L. Mills R.H. Knopp J.L. Simpson National Institute of Child Health and Human Development Diabetes in Early Pregnancy Study: Lack of relation of increased malformation rates in infants of diabetic mothers to glycemic control during organogenesis N Engl J Med 318 1988 671 676
88. M. Miodovnik F. Mimouni P.S.J. Dignam Major malformations in infants of IDDM women Diabetes Care 11 1988 713 718
89. L. Mølsted Pedersen C. Kühl Obstetrical management in diabetic pregnancy: The Copenhagen experience Diabetologia 29 1986 13 16
90. L. Mølsted Pedersen I. Tygstrups J. Pedersen Congenital malformations in newborn infants of diabetic women: Correlation with maternal diabetic vascular complications Lancet I 1964 1124
91. D.C.P. Moore M. Stanisstreet C.A. Clarke Morphological and physiological effects of β-hydroxybutyrate on rat embryos grown in vitro at different stages Teratology 40 1989 237 251
92. D.A.T. New Whole-embryo culture and the study of mammalian embryos during organogenesis Biol Rev 53 1978 81
93. P. Olofsson H. Liedholm G. Sartor Diabetes and pregnancy: A 21-year Swedish material Acta Obstet Gynaecol Scand 63 suppl 122 1984 1
94. P. Olofsson N.O. Sjöberg T. Solum Changing panorama of perinatal and infant mortality in diabetic pregnancy Acta Obstet Gynaecol Scand 63 1984 467
95. L.S. Phillips D.C. Belosky L.A. Reichard Nutrition and somatomedin. V. Action and measurement of somatomedin inhibitor(s) in serum from diabetic rats Endocrinology 104 1979 1513
96. J. Pedersen The Pregnant Diabetic and Her Newborn: Problems and Management ed 2 1977 Williams & Wilkins Baltimore
97. E. Pinter E.A. Reece C. Leranth Arachidonic acid prevents hyperglycemiaassociated yolk sac damage and embryopathy Am J Obstet Gynecol 155 1986 691 702
98. E. Pinter E.A. Reece C.Z. Leranth Surface alterations of the embryonic blood cells and the visceral endodermal yolk sac layer under hyperglycemic conditions revealed by scanning electron microscopy [abstract] Proc Soc Perinatal Obstet 1986 25
99. E. Pinter E.A. Reece C.Z. Leranth Yolk sac failure in embryopathy due to hyperglycemia: Ultrastructural analysis of yolk sac differentiation associated with embryopathy in rat conceptuses under hyperglycemic conditions Teratology 33 1986 73
100. E. Pinter E.A. Reece P. Ogbum Relative essential fatty acid deficiency in hyperglycemia-induced embryopathy Am J Obstet Gynecol 159 1988 1484 1490
101. A.L. Rabinovitch M.A. Gibson Skeletogenesis in insulin-treated chick embryos. II. Histochemical observations, with particular reference to the tibiotarsus Teratology 6 1972 51 70
102. W. Rayburn F. Piehl S. Jacober Severe hypoglycemia during pregnancy: Its frequency and predisposing factors in diabetic women Int Gynaecol Obstet 24 1986 263 268
103. J.R. Ream Jr P.L. Weingarten A.M. Pappas Evaluation of the prenatal effects of massive doses of insulin in rats Teratology 3 1970 29 32
104. E.A. Reece C.J. Homko A. Wiznitzer Hypoglycemia in pregnancies complicated by diabetes mellitus: Maternal and fetal considerations Clin Obstet Gynecol 37 1994 50 58
105. E.A. Reece E. Pinter C. Homko The yolk sac theory: Closing the circle on why diabetes associated malformations occur J Soc Gynecol Invest 1 1994 3 13
106. E.A. Reece E.A. Pinter C.Z. Leranth Malformations of the neural tube induced by in vitro hyperglycemia: An ultrastructural analysis Teratology 32 1985 363
107. E.A. Reece E. Pinter C.Z. Leranth Yolk sac failure in embryopathy due to hyperglycemia: Horseradish peroxidase uptake in the assessment of yolk sac dysfunction Obstet Gynecol 74 1989 755 762
108. Reece EA, Wiznitzer A, Homko CJ, et al: Synchronization of the factors critical for diabetic teratogenesis: An in vitro model. Am J Obstet Gynecol, in press
109. Reece EA, Wu Y-K, Borenstein M, et al: Dietary polyunsaturated fatty acid prevents malformations in offspring [abstract]. Am J Obstet Gynecol, submitted
110. Reece EA, Sivan E, Homko CJ, et al: Perinatal outcomes among women with and without diabetic vasculopathy versus non-diabetic controls. Am J Obstet Gynecol, submitted
111. B. Rosenn M. Miodowvnik C.A. Coms Preconception management of insulin-dependent diabetes: Improvement of pregnancy outcome Obstet Gynecol 77 1991 846 849
112. T.W. Rowland J.P. Hubbell A.S. Nadas Congenital heart disease in infants of diabetic mothers J Pediatr 83 1973 815
113. T.W. Sadler Effects of maternal diabetes on early embryogenesis. II. Hyperglycemia-induced exencephaly Teratology 21 1980 349
114. T.W. Sadler W.E. Horton Whole embryo culture: A screening technique for teratogens? Teratogenesis Carcinog Mutagen 2 1982 243
115. T.W. Sadler W.E. Horton Jr Effects of maternal diabetes on early embryogenesis: The role of insulin and insulin therapy Diabetes 32 1983 1070 1074
116. T.W. Sadler E.S. Hunter III Hypoglycemia: How little is too much for the embryo? Am J Obstet Gynecol 157 1987 190 193
117. T.W. Sadler L.S. Phillips W. Balkan Somatomedin inhibitors from diabetic rat serum alter growth and development of mouse embryos in culture Diabetes 35 1986 861
118. G.E. Shambaugh III M.C. Angulo R.R. Koehler Fetal fuels. VII. Ketone bodies inhibit synthesis of purines in fetal rat brain Am J Physiol 247 1984 E111 E117
119. E.A. Sheehan F. Beck C.A. Clarke Effects of β-hydroxybutyrate on rat embryos grown in culture Experientia 41 1985 273 275
120. J.L. Sherman S. Elias A.O. Martin Diabetes in pregnancy, Northwestern University series (1977-1981). I. Prospective study of anomalies in offspring of mothers with diabetes mellitus Am J Obstet Gynecol 146 1983 263
121. Sivan E, Wu Y-K, Homko CJ, et al: Dietary vitamin E prophylaxis and diabetic embryopathy: Morphological, biochemical and molecular analyses [abstract]. Am J Obstet Gynecol, submitted
122. D.O. Slauson B.J. Cooper Mechanisms of Disease. A Textbook of Comparative General Pathology 1982 Williams & Wilkins Baltimore
123. M. Smithberg M.N. Runner Teratogenic effects of hypoglycemic treatments in inbred strains of mice Am J Anat 113 1963 479 489
124. N.G. Soler C.H. Walsh J.M. Malins Congenital malformations in infants of diabetic mothers QJ Med 45 1976 303
125. J. Steinke S. Driscoll The extractable insulin content of pancreas from fetuses and infants of diabetic and control mothers Diabetes 14 1965 573
126. P.J. Strieleman M.A. Connors B.E. Metzger Phosphoinositide metabolism in the developing conceptus: Effects of hyperglycemia and scyllo-inositol in rat embryo culture Diabetes 41 1992 989 997
127. P.J. Strieleman B.E. Metzger Glucose and scyllo-inositol impair phosphoinositide hydrolysis in the 10.5 day cultured rat conceptus: A role in dysmorphogenesis? Teratology 48 1993 267 278
128. J. Styrud U.J. Eriksson Effects of D-glucose and β-hydroxybutyric acid on the in vitro development of (pre)chondrocytes from embryos of normal and diabetic rats Acta Endocrinol (Copenh) 122 1990 487 498
129. J. Styrud L. Thunberg O. Nybacka Correlations between maternal metabolism and deranged development in the offspring of normal and diabetic rats Pediatr Res 37 1995 343 353
130. I. Sussman F.M. Matschinsky Diabetes affects sorbitol and myo -inositol levels of neuroectodermal tissue during embryogenesis in rat Diabetes 37 1988 974 981
131. B.F. Trump J.K. Berezesky Cellular ion regulation and disease: A hypothesis Curr Top Membr Transport 25 1985 279
132. R.C. Tsang J. Ballard C. Braun The infants of the diabetic mother: Today and tomorrow Clin Obstet Gynecol 24 1981 125
133. J. Warkany R.J. Lemire Arteriovenous malformations of the brain: A teratologic challenge Teratology 29 1984 333
134. M.J. Weigensberg F.J. Garcia-Palmer N. Freinkel Uptake of myo -inositol by earlysomite rat conceptus: Transport kinetics and effects of hyperglycemia Diabetes 39 1990 575 582
135. P. White Diabetes mellitus in pregnancy Clin Perinatol 1 1974 331
136. P. White Pregnancy and diabetes medical aspects Med Clin North Am 49 1965 1015
137. P. White Pregnancy complicating diabetes Am J Med 7 1949 609
138. P. White Pregnancy complicating diabetes E.P. Joslin The Treatment of Diabetes Mellitus ed 6 1937 Henry Klimpton London 618
139. G.D. Windham L.D. Edmonds Current trends in the incidence of neural tube defect Pediatrics 70 1982 33
140. X. Yang L.A.H. Borg U.J. Eriksson Altered mitochondrial morphology of rat embryos in diabetic pregnancy Anat Rec 241 1995 255 267
141. 1c values in early pregnancy BMJ 289 1984 345 346
142. I. Zusman A. Ornoy P. Yaffe Effects of glucose and serum from streptozotocin-diabetic and non-diabetic rats on the in vitro development of preimplantation mouse embryos Isr J Med Sci 21 1985 359 365
143. I. Zusman P. Yaffe A. Ornoy Effects of metabolic factors in the diabetic state on the in vitro development of preimplantation mouse embryos Teratology 35 1987 77 85
144. E. Zwilling Association of hypoglycemia with insulin micromelia in chick embryos J Exp Zool 109 1948 197 214