Does hyperglycemia in pregnancy change fetal kidney growth?: a longitudinal prospective study

Neves, Haroldo Millet; Sgarbosa, Fábio; Calderon, Iracema de Mattos Paranhos; Vianna, Luana Schneider; Santini, Ana Carolina Monteiro; Netto, Lino Sieiro; Dias, Adriano

doi:10.1590/s0100-72032013001000003

Cited by 7 publications

(11 citation statements)

References 17 publications

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“…Included studies (n = 9) were published between 1994 and 2014 and were conducted in 12 countries including the United States of America, [28][29][30] Netherlands, 31,32 Canada, 33 France, 34 Italy 35 and Brazil. 36 The most common measures of kidney structure were kidney volume and length, while kidney function measures were albuminuria, albumin/creatinine and GFR. Two studies evaluated the relative risk of developing renal disease in later life.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Four studies did not specify the exact numbers for each sex. 29,31,35,36 There was a wide range in the age of offspring at the time of assessment, from late gestation to approximately 40 years of age.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…All of the included studies were observational study designs (Table 1). Seven observational studies evaluated the relationship between maternal hyperglycemia during pregnancy and offspring kidney structure and function, of which, one was a cross-sectional study, 31 four were prospective cohort studies 29,33,35,36 and two were retrospective cohort studies. 28,34 One prospective cohort study evaluated the relationship between maternal obesity and offspring kidney structure and function 32 and another retrospective cohort study evaluated the relationship between both maternal hyperglycemia and obesity during pregnancy and offspring kidney structure and function.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In this study, 32 important confounding factors were accounted for by appropriate adjustments in the statistical analyses. Six (66.7%) studies 28,30,[33][34][35][36] were rated as of neutral quality, as it was unclear whether data collectors were blinded to study outcomes and risk factor assessments. It was also unclear whether important confounders were accounted for in statistical analyses.…”

Section: Risk Of Bias Of Included Studiesmentioning

confidence: 99%

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The relationship between maternal obesity and diabetes during pregnancy on offspring kidney structure and function in humans: a systematic review

Lee

Collins

Gordon

et al. 2018

J Dev Orig Health Dis

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Evidence from animal models indicates that exposure to an obesogenic or hyperglycemic intrauterine environment adversely impacts offspring kidney development and renal function. However, evidence from human studies has not been evaluated systematically. Therefore, the aim of this systematic review was to synthesize current research in humans that has examined the relationship between gestational obesity and/or diabetes and offspring kidney structure and function. Systematic electronic database searches were conducted of five relevant databases (CINAHL, Cochrane, EMBASE, MEDLINE and Scopus). Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were followed, and articles screened by two independent reviewers generated nine eligible papers for inclusion. Six studies were assessed as being of ‘neutral’ quality, two of ‘negative’ and one ‘positive’ quality. Observational studies suggest that offspring exposed to a hyperglycemic intrauterine environment are more likely to display markers of renal dysfunction and are at higher risk of end-stage renal disease. There was limited and inconsistent evidence for a link between exposure to an obesogenic intrauterine environment and offspring renal outcomes. Offspring renal outcome measures across studies were diverse, with a large variation in offspring age at follow-up, limiting comparability across studies. The collective current body of evidence suggests that intrauterine exposure to maternal obesity and/or diabetes adversely impacts renal programming in offspring, with an increased risk of kidney disease in adulthood. Further high-quality, longitudinal, prospective cohort studies that measure indicators of offspring renal development and function, including fetal kidney volume and albuminuria, at standardized follow-up time points, are warranted.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Risk Of Bias Of Included Studiesmentioning

confidence: 99%

See 2 more Smart Citations

The relationship between maternal obesity and diabetes during pregnancy on offspring kidney structure and function in humans: a systematic review

Lee

Collins

Gordon

et al. 2018

J Dev Orig Health Dis

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“…While one study found normal foetal kidney volume in diabetic pregnancies (pregestational diabetes and GDM pregnancies grouped together), 38 another found increased foetal kidney volume in pregnancies of women with GDM. 39 A third preliminary study reported reduced renal cortical volume and increased albumin excretion in 3-year-old children whose mothers had GDM, taken to suggest a reduction in nephron endowment and glomerular impairment. 40 Overall, evidence for the extent to which GDM affects developing human kidneys is not robust.…”

Section: Introductionmentioning

confidence: 98%

Normal foetal kidney volume in offspring of women treated for gestational diabetes

Hokke

Zoysa

Carr

et al. 2019

Endocrino Diabet & Metabol

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Aims The worldwide prevalence of gestational diabetes mellitus (GDM) is increasing. Studies in rodent models indicate that hyperglycaemia during pregnancy alters kidney development, yet few studies have examined if this is so in humans. The objective of this study was to evaluate the association of treated GDM with foetal kidney size. Materials and Methods Participants were recruited from an Australian tertiary hospital, and clinical data were collected from women without GDM and women diagnosed and treated for GDM and their offspring. Participants underwent an obstetric ultrasound at 32‐34 weeks gestation for foetal biometry and foetal kidney volume measurement. Results Sixty‐four non‐GDM and 64 GDM women participated in the study. Thirty percent of GDM women were diagnosed with fasting hyperglycaemia, while 89% had an elevated 2‐hour glucose level. Maternal age, weight and body mass index were similar in women with and without GDM. Estimated foetal weight, foetal kidney dimensions, total foetal kidney volume and birth weight were similar in offspring of women with and without GDM. Conclusions We conclude that a period of mild hyperglycaemia prior to diagnosis of GDM and treatment initiation, which coincides with a period of rapid nephron formation and kidney growth, does not alter kidney size at 32‐34 weeks gestation.

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Zusammenhang zwischen Gestationsdiabetes und der Größe der fetalen Niere?

Stupin

2019

Info Diabetol

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Does hyperglycemia in pregnancy change fetal kidney growth?: a longitudinal prospective study

Abstract: This is important for early detection of abnormalities in pregnancy, particularly in diabetic mothers.

Cited by 7 publications

References 17 publications

The relationship between maternal obesity and diabetes during pregnancy on offspring kidney structure and function in humans: a systematic review

The relationship between maternal obesity and diabetes during pregnancy on offspring kidney structure and function in humans: a systematic review

Normal foetal kidney volume in offspring of women treated for gestational diabetes

Zusammenhang zwischen Gestationsdiabetes und der Größe der fetalen Niere?

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