Birth defects resulting from diabetic pregnancy are associated with apoptosis of a critical mass of progenitor cells early
during the formation of the affected organ(s). Insufficient expression of genes that regulate viability of the progenitor
cells is responsible for the apoptosis. In particular, maternal diabetes inhibits expression of a gene,
Pax3, that encodes a transcription factor which is expressed in neural crest and neuroepithelial cells. As a result of insufficient
Pax3, cardiac neural crest and neuroepithelial cells undergo apoptosis by a process dependent on the p53 tumor suppressor
protein. This, then provides a cellular explanation for the cardiac outflow tract and neural tube and defects induced by diabetic
pregnancy.
Keywords Diabetic pregnancy - Congenital defects - Neural tube defect - Cardiac outflow tract defect - Apoptosis - Oxidative stress - Pax3 - p53