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

Author

Listed:
  • Alena Kirzhner

    (Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Rehovot 9190401, Israel
    Department of Medicine, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Rehovot 9190401, Israel)

  • Oren Barak

    (Department of Obstetrics and Gynecology, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Rehovot 9190401, Israel
    Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA
    Department of Obstetrics, Gynecology and Reproductive Science, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA)

  • Edi Vaisbuch

    (Department of Obstetrics and Gynecology, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Rehovot 9190401, Israel)

  • Taiba Zornitzki

    (Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Rehovot 9190401, Israel)

  • Tal Schiller

    (Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Rehovot 9190401, Israel)

Abstract

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.

Suggested Citation

  • Alena Kirzhner & Oren Barak & Edi Vaisbuch & Taiba Zornitzki & Tal Schiller, 2022. "The Challenges of Treating Glucokinase MODY during Pregnancy: A Review of Maternal and Fetal Outcomes," IJERPH, MDPI, vol. 19(10), pages 1-11, May.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:10:p:5980-:d:815753
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