Which fetal anomalies are associated with pregestational diabetes?

Pregestational diabetes has been associated with a specific range of fetal anomalies, most notably sacral agenesis and cardiac anomalies. Sacral agenesis is characterized by the partial or complete absence of the sacrum, leading to a spectrum of musculoskeletal and neurological deficits. This condition is particularly linked to maternal diabetes due to the teratogenic effects of hyperglycemia, especially in the early weeks of gestation.

Cardiac anomalies are also more prevalent in infants born to mothers with pregestational diabetes. Studies indicate that this condition can lead to various structural heart defects, including outflow tract obstructions and septal defects. The exact mechanism by which diabetes leads to these cardiac anomalies is complex and is thought to involve metabolic derangements caused by poorly controlled blood sugar levels during critical periods of fetal development.

This association emphasizes the importance of proper management of blood glucose levels before and throughout pregnancy to minimize the risk of these serious congenital defects. In contrast, while other options list conditions related to maternal diabetes, they do not represent the most common or significant fetal anomalies linked specifically to pregestational diabetes.