{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:10:01Z","timestamp":1781244601598,"version":"3.54.1"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2008,1,7]],"date-time":"2008-01-07T00:00:00Z","timestamp":1199664000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2008,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>BACKGROUND:<\/jats:bold> Some factors(s)\/features(s) of maternal insulin\u2010dependent diabetes mellitus are considered common human teratogens. Although the variable association of cardiac, renal, and skeletal anomalies are commonly observed in infants from diabetic mothers, the relationship between VACTERL (i.e., the association of vertebral and cardiac defects, tracheo\u2010esophageal fistula, renal\/radial malformations, and other limb anomalies) and maternal diabetes has not been sufficiently emphasized in the literature. <jats:bold>CASE:<\/jats:bold> We report on a 3\u2010year\u2010old boy presenting with a constellation of blastogenetic malformations strongly suggestive of VACTERL association. His mother was affected by insulin\u2010dependent diabetes since she was 7 years old and pregnancy history disclosed very high glucose and HbA1c levels, especially during the first 2 gestational months. <jats:bold>CONCLUSIONS:<\/jats:bold> In an attempt to properly counsel the parents, we reviewed the literature and identified four additional patients with VACTERL and first trimester exposure to maternal diabetes mellitus. Although this evidence does not strongly support a causal relationship between these two conditions, additional arguments may substantiate this hypothesis. The pathogenesis of diabetic embryopathy in relation to the VACTERL phenotype is also discussed. Birth Defects Research (Part A), 2008. \u00a9 2008 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/bdra.20432","type":"journal-article","created":{"date-parts":[[2008,1,8]],"date-time":"2008-01-08T00:46:16Z","timestamp":1199753176000},"page":"169-172","source":"Crossref","is-referenced-by-count":36,"title":["VACTERL association and maternal diabetes: A possible causal relationship?"],"prefix":"10.1002","volume":"82","author":[{"given":"Marco","family":"Castori","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosanna","family":"Rinaldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Capocaccia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Roggini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Grammatico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,1,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-4520.2005.00070.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.85.1.1"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19991119)87:2<99::AID-AJMG1>3.0.CO;2-Q"},{"key":"e_1_2_6_5_1","first-page":"219","article-title":"The Vater association in a newborn infant of a diabetic mother","volume":"40","author":"Boutte P","year":"1985","journal-title":"Pediatrie"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.10258"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320550427"},{"key":"e_1_2_6_8_1","first-page":"607","volume-title":"Management of Genetic Syndromes","author":"Hall BD","year":"2005"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.71.5.815"},{"key":"e_1_2_6_10_1","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1542\/peds.87.3.390","article-title":"VACTERL association with high prenatal lead exposure: similarities to animal models of lead teratogenicity","volume":"87","author":"Levine F","year":"1991","journal-title":"Pediatrics"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/tera.1051"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19990305)83:1<13::AID-AJMG4>3.0.CO;2-X"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.31.5.423"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/tera.1420250316"},{"key":"e_1_2_6_15_1","doi-asserted-by":"crossref","first-page":"292","DOI":"10.2337\/diab.28.4.292","article-title":"Malformations in infants of diabetic mothers occur before the seventh gestational week. 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