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Lancet Diabetes Endocrinol. 2019 Oct;7(10):796-806. doi: 10.1016/S2213-8587(19)30078-6. Epub 2019 May 22.

Diabetes in pregnancy and epigenetic mechanisms-how the first 9 months from conception might affect the child's epigenome and later risk of disease.

Author information

1
Department of Endocrinology, Diabetes and Bone-metabolic Research Unit, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Center for Pregnant Women with Diabetes, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; The Danish Diabetes Academy, Odense, Denmark. Electronic address: line.hjort@regionh.dk.
2
Cancer and Disease Epigenetics, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Pediatrics, Melbourne University, Melbourne, VIC, Australia.
3
Department of Endocrinology, Diabetes and Bone-metabolic Research Unit, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; The Danish Diabetes Academy, Odense, Denmark.
4
Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia; Endocrinology Department, Royal Darwin Hospital, Darwin, NT, Australia.
5
Center for Pregnant Women with Diabetes, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
6
Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria.

Abstract

Diabetes in pregnancy is not only associated with increased risk of pregnancy complications and subsequent maternal metabolic disease, but also increases the risk of long-term metabolic disease in the offspring. At the interface between genetic and environmental factors, epigenetic variation established in utero represents a plausible link between the in utero environment and later disease susceptibility. The identification of an epigenetic fingerprint of diabetes in pregnancy linked to the metabolic health of the offspring might provide novel biomarkers for the identification of offspring most at risk, before the onset of metabolic dysfunction, for targeted monitoring and intervention. In this Personal View, we (1) highlight the scale of the problem of diabetes in pregnancy, (2) summarise evidence for the variation in offspring epigenetic profiles following exposure to diabetes in utero, and (3) outline potential future approaches to further understand the mechanisms by which exposure to maternal metabolic dysfunction in pregnancy is transmitted through generations.

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