Fetal Sex, Need for Insulin, and Perinatal Outcomes in Gestational Diabetes Mellitus: An Observational Cohort Study
Fetal Sex, Need for Insulin, and Perinatal Outcomes in Gestational Diabetes Mellitus: An Observational Cohort Study
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DOI：
10.1016/j.clinthera.2018.02.015
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发表时间：
2018-04-01
影响因子：
3.2
通讯作者：
Ciavattini, Andrea
中科院分区：
文献类型：
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作者：
Giannubilo, Stefano Raffaele;Pasculli, Angela;Ciavattini, Andrea
目的：这是一项前瞻性观察队列研究，旨在确定胎儿性别是否影响妊娠期糖尿病（GDM）的母婴结局。方法：本研究连续招募327名诊断为GDM的欧洲初产妇。记录并比较两亚组女性和男性胎儿的口服葡萄糖耐量试验（OGTT）、胰岛素治疗需求、产妇和产科结局以及胎儿脂肪量（通过测量腹前皮下组织厚度）的AUC。结果：尽管在OGTT的多重比较中没有差异，但携带男性胎儿的女性AUC-OGTT明显更高（22.6 [3.2]mmol/L vs 19.7 [2.8] mmol/L）。腹部脂肪厚度随胎龄增加，男胎比女胎增长更快。需要胰岛素治疗的总体风险在怀男性胎儿的女性中明显更高（优势比= 1.837）。在分娩时，只有经胎龄调整后，男性的出生体重才高于女性，胎盘重量也是如此，除此之外，两组在总妊娠期、剖宫产率和Apgar评分方面没有显著差异。(C) 2018 Elsevier HS Journals, Inc.；版权所有。
Purpose: This was a prospective observational cohort study that aimed to determine whether fetal sex influences the maternal and fetal outcomes of gestational diabetes mellitus (GDM).Methods: In this study, 327 European primiparous women were consecutively recruited after diagnosis of GDM. AUC on the oral glucose tolerance test (OGTT), need for insulin therapy, maternal and obstetrical outcomes, and fetal fat mass (by measuring the thickness of the anterior abdominal subcutaneous tissue) were recorded and compared between the two subgroups of female and male fetuses.Findings: Despite the absence of differences in multiple comparisons of the OGTT, the AUC-OGTT was significantly higher in women carrying a male fetus (22.6 [3.2] mmol/L vs 19.7 [2.8] mmol/L). The abdominal fat thickness appeared to increase with gestational age, with higher growth in male fetuses than in female fetuses. The overall risk of need for insulin therapy was significantly higher in women carrying a male fetus (odds ratio = 1.837). At delivery, birthweight was higher in males than in females only if adjusted for gestational age, similarly for placental weight, otherwise there were no significant differences between the groups in total length of gestation, rates of cesarean delivery, and Apgar scores. (C) 2018 Elsevier HS Journals, Inc. All rights reserved.