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The effects of gestational diabetes mellitus on fetal growth: is it different for low-risk and medium–high-risk pregnant women?

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

It has been suggested that gestational diabetes mellitus (GDM) alters the growth trajectory of a fetus and increases the risk of abnormal birth weight. In spite of this, there is still a significant debate regarding the mode and optimal timing of diagnosing this condition. Our aim was to determine fetal growth velocity and birth biometry in pregnant women with GDM at varying risk levels.

Methods

We conducted a cohort study involving 1023 pregnant women at a maternity hospital in Ma’anshan, China. All women completed an oral glucose tolerance test at 24–28 weeks’ gestation. We measured fetal head circumference (HC), femoral length (FL), abdominal circumference (AC), biparietal diameter (BPD), and estimate fetal weight (EFW) by ultrasound at 17, 24, 31, and 35 weeks’ gestation, respectively.

Results

Overall, 5115 ultrasound scans were performed. Among both low-risk and medium–high-risk pregnant women at 17–24 weeks’ gestation, GDM exposure was associated with an increase in fetal growth velocity. Neonates born to women with GDM at medium–high risk had significantly larger birth weights than those born to women without GDM, while this was not observed in women at low risk.

Conclusion

In medium–high-risk pregnant women, exposure to GDM has a greater effect on the fetus, leading to abnormal fetal growth velocity that lasts beyond week 24. It is evident from our results that the effects of GDM on fetal growth differ between medium–high-risk pregnant women and low-risk pregnant women, and therefore a different screening program based on the risk factor for GDM is warranted.

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Data availability

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

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Acknowledgements

The authors wish to acknowledge the support of the Anhui Medical University and Ma'anshan Maternal and Child Health Hospital, as well as the mothers who informed for our study.

Funding

This research was funded by the National Natural Science Foundation of China (Grant No. 82073565), and Scientific Research Promotion Plan of Anhui Medical University (Grant No. 2021xkjT013).

Author information

Author notes

  1. Jie Wang, Xin Cheng, and Zhen-Hua Li have contributed equally to this study.

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China

    Jie Wang, Xin Cheng, Zhen-Hua Li, Yi-Cheng Mao, Xin-Qiang Wang, Kang-Di Zhang, Wen-Jie Yu, Ying-Qing Li, Jia-wen Zhao & Xiu-Jun Zhang

  2. Department of Gynecology and Obstetrics, Ma’anshan Maternal and Child Health Hospital, Ma’anshan, 243000, China

    Mao-Lin Chen & Guo-peng Gao

  3. Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China

    Cheng-Yang Hu

  4. Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, 81 Meishan Road, Hefei, 230032, China

    Xiu-Jun Zhang

Authors
  1. Jie Wang
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Contributions

XZ and JW: designed the research. XC and JW: wrote the original manuscript. KZ, XC, and CH: reviewed and edited the manuscript. YL, XW, WY, and YM: performed the experiments. ZL and MC: helped with data collection. JZ, GG, and KZ: performed the statistical analysis. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Xiu-Jun Zhang.

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Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Ethics approval was obtained from Anhui Medical University (No. 20200592).

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All study participants provided the written informed consent.

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Wang, J., Cheng, X., Li, ZH. et al. The effects of gestational diabetes mellitus on fetal growth: is it different for low-risk and medium–high-risk pregnant women?. Arch Gynecol Obstet (2023). https://doi.org/10.1007/s00404-023-07229-9

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