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Fetal brain development in pregnancies complicated by gestational diabetes mellitus

  • Maria Chiara Marra , Ilenia Mappa , Maria Elena Pietrolucci , Jia Li Angela Lu , Francesco D’ Antonio und Giuseppe Rizzo ORCID logo EMAIL logo
Veröffentlicht/Copyright: 18. Januar 2024
Journal of Perinatal Medicine
Aus der Zeitschrift Journal of Perinatal Medicine Band 52 Heft 3

Abstract

Objectives

Gestational diabetes mellitus (GDM) carries an increased risk of neurocognitive impairment in offsprings. However, the contribution of maternal hyperglycemia in affecting fetal brain development is not fully elucidated yet. The aim of this study was to evaluate fetal brain and sulci development in pregnancies complicated by GDM.

Methods

Prospective observational study including 100 singleton pregnancies complicated by GDM and 100 matched controls. All fetuses underwent neurosonography at 29–34 weeks of gestation, including the assessment of the length of the corpus callosum (CC), cerebellar vermis (CV), Sylvian (SF), parieto-occipital (POF) and calcarine fissures (CF). Sub-group analysis according to the specific treatment regimen adopted (n 67 diet vs. 33 insulin therapy) was also performed.

Results

Fetuses from mothers with GDM under insulin therapy had a smaller CC (35.54 mm) compared to both controls (40 mm; p<0.001) and women with GDM under diet (39.26 mm; p=0.022) while there was no difference in the HC between the groups. Likewise, when corrected for HC, CV depth was smaller in fetuses with GDM both under insulin therapy (7.03 mm) and diet (7.05 mm,) compared to controls (7.36 mm; p=0.013). Finally, when assessing the sulci development of the brain SF (p≤0.0001), POF (p≤0.0001) and CF (p≤0.0001) were significantly smaller in fetuses with maternal GDM. Post-hoc analysis showed that fetuses of GDM mothers requiring insulin therapy had significantly lower values of SF (p=0.032), POF (p=0.016) and CF (p=0.001).

Conclusions

Pregnancies complicated by GDM showed a peculiar pattern of fetal brain growth and cortical development and these changes, which are more evident in those requiring insulin supplementation.

Keywords: neurosongraphy; fetal brain; cortical folding; corpus callosum; gestational diabetes mellitus
Corresponding author: Giuseppe Rizzo, MD, Department of Obstetrics and Gynecology, Fondazione Policlinico Tor Vergata, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italy, Phone: +39 06 2090 2750, E-mail:
Maria Chiara Marra and Ilenia Mappa contributed equally to this work and share first authorship.

Funding source: PNRR Project of the European Union

Award Identifier / Grant number: MNESYS agreement number E83C22004710001

  1. Research ethics: The study was approved by our Institutional Ethical Board (May 31, 2022, Protocol n° 110/2022).

  2. Informed consent: All women included in the study signed an informed consent.

  3. Author contributions: All authors provided substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Competing interest: The authors state no competing interest.

  5. Research funding: The study was supported by a grant of the Italian Ministry of University and Research (MUR PE00000006 MNESYS PNRR). This project was partially funded with support from PNRR Project of the European Union (MNESYS agreement number E83C22004710001).

  6. Data availability: Data are available on reasonable request.

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/jpm-2023-0456).

Received: 2023-10-26
Accepted: 2023-12-23
Published Online: 2024-01-18
Published in Print: 2024-03-25

© 2024 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Frontmatter
  2. Opinion Paper
  3. The importance of professional responsibility and fetal viability in the management of abortion
  4. Corner of Academy
  5. Multifetal pregnancy reductions and selective fetocide in a tertiary referral center – a retrospective cohort study
  6. Original Articles – Obstetrics
  7. Cervical length as a screening tool for preterm birth in twin pregnancies: a systematic review and critical evaluation of quality clinical practice guidelines
  8. Determinants of prematurity in urban Indonesia: a meta-analysis
  9. Predictors of planned home birth before and during the COVID-19 pandemic
  10. Sensitivity of antenatal ultrasound in diagnosing posterior placenta accreta spectrum disorders
  11. The prognostic role of CRL discordance in first trimester ultrasound
  12. Evaluation of postpartum shock index in hypertensive diseases of pregnancy: a case-control study from a tertiary reference center
  13. Original Articles – Fetus
  14. Prenatal diagnosis of right aortic arch: associated anomalies and fetal prognosis according to different subtypes
  15. Fetal brain development in pregnancies complicated by gestational diabetes mellitus
  16. The association between parental SARS-CoV-2 infection in pregnancy and fetal growth restriction
  17. Subclinical cardiac impairments in fetuses conceived through assisted reproductive technology by speckle tracking echocardiography
  18. Original Articles – Neonates
  19. Coagulation assessment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infected pregnant women and their offspring by using rotational thromboelastometry (ROTEM)
  20. Comprehensive appraisal of pregnancy and neonatal outcomes in singleton pregnancies conceived via in vitro fertilization in the USA (2016–2021)
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https://doi.org/10.1515/jpm-2023-0456
Schlagwörter für diesen Artikel
neurosongraphy; fetal brain; cortical folding; corpus callosum; gestational diabetes mellitus

Artikel in diesem Heft

  1. Frontmatter
  2. Opinion Paper
  3. The importance of professional responsibility and fetal viability in the management of abortion
  4. Corner of Academy
  5. Multifetal pregnancy reductions and selective fetocide in a tertiary referral center – a retrospective cohort study
  6. Original Articles – Obstetrics
  7. Cervical length as a screening tool for preterm birth in twin pregnancies: a systematic review and critical evaluation of quality clinical practice guidelines
  8. Determinants of prematurity in urban Indonesia: a meta-analysis
  9. Predictors of planned home birth before and during the COVID-19 pandemic
  10. Sensitivity of antenatal ultrasound in diagnosing posterior placenta accreta spectrum disorders
  11. The prognostic role of CRL discordance in first trimester ultrasound
  12. Evaluation of postpartum shock index in hypertensive diseases of pregnancy: a case-control study from a tertiary reference center
  13. Original Articles – Fetus
  14. Prenatal diagnosis of right aortic arch: associated anomalies and fetal prognosis according to different subtypes
  15. Fetal brain development in pregnancies complicated by gestational diabetes mellitus
  16. The association between parental SARS-CoV-2 infection in pregnancy and fetal growth restriction
  17. Subclinical cardiac impairments in fetuses conceived through assisted reproductive technology by speckle tracking echocardiography
  18. Original Articles – Neonates
  19. Coagulation assessment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infected pregnant women and their offspring by using rotational thromboelastometry (ROTEM)
  20. Comprehensive appraisal of pregnancy and neonatal outcomes in singleton pregnancies conceived via in vitro fertilization in the USA (2016–2021)
  21. Influence of donor characteristics on the milk donation volume and microbiological quality of donated human milk in first 3 years of work of the Croatian human milk bank-retrospective observational study
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