Unilateral bowing of long bones and multiple congenital anomalies in a child born to a mother with gestational diabetes

We report on a new-born girl with multiple congenital anomalies consisting of major skeletal anomalies restricted to the left side, cleft palate, vent ricular and atrial septal defect, retromicrognathia, short neck, dysplastic low-set ears and large birth weight. The left-side bony anomalies include shortening and bowing of the femur and tibia, hypoplasia of the fibula, hip dislocation, clubfoot and mild shortening of the long tubular bones in the left arm with elbow dislocation. The pregnancy was complicated by insulin- dependent gestational diabetes mellitus in the mother. The radiographic fea tures were not consistent with the diagnosis of campomelic dysplasia, kypho melic dysplasia or other skeletal dysplasias characterized by bowing and sh ortening of the long bones. To our knowledge, the multiple congenital anoma lies, including major skeletal malformations, present in our case have neve r been simultaneously reported until now. A maternal diabetes syndrome in t his infant is probable. The occurrence of major congenital malformations in offspring of women with gestational diabetes is reviewed and discussed. We provide evidence that gestational diabetes mellitus could be teratogenic. We recommend a careful diabetic control in every women with a history of ge stational diabetes. (C) 2000 Editions scientifiques et medicales Elsevier S AS.