Fetal adrenal gland size in gestational diabetes mellitus

Abstract

Background The aim of this study was to compare the adrenal gland size of fetuses of women with gestational diabetes mellitus (GDM) with that of healthy control fetuses. Methods This prospective cross-sectional study included measurements of the adrenal gland size of 62 GDM fetuses (GDM group) and 370 normal controls (control group) between the 19th and 41st week of gestation. A standardized transversal plane was used to measure the total width and the medulla width. The cortex width and an adrenal gland ratio (total width/medulla width) were calculated from these data. Adrenal gland size measurements were adjusted to the week of gestation and compared between the two groups in a multivariable linear regression analysis. A variance decomposition metric was used to compare the relative importance of predictors of the different adrenal gland size measurements. Results For all the investigated parameters of the adrenal gland size, increased values were found in the case of GDM (P < 0.05), while adjusting for the week of gestation. GDM seems to have a greater impact on the size of the cortex than on the size of the medulla. Conclusion The fetal adrenal gland is enlarged in pregnancy complicated by GDM. The width of the cortex seems to be particularly affected.

Prenatal Assessment of Atypical Adrenal Glands

“…When bilaterally increased in size and associated with a normal US appearance, this may indicate adrenal hypertrophy, which can be encountered in some cases of gestational diabetes, intrauterine growth restriction, and fetal inflammatory syndrome, especially in cases of premature rupture of the membranes. 13,14 In bilateral cases with an abnormal US appearance, CAH should be suspected (case 1; Table 1 and Figure 3). This autosomal recessive disorder may be indicated by an association with 2 US features: a typical aspect of "cerebriform" adrenal glands, associated with virilization of the genitalia.…”

“… 12 First, a bilateral or unilateral presentation should be considered, followed by its US appearance. When bilaterally increased in size and associated with a normal US appearance, this may indicate adrenal hypertrophy, which can be encountered in some cases of gestational diabetes, intrauterine growth restriction, and fetal inflammatory syndrome, especially in cases of premature rupture of the membranes 13,14 . In bilateral cases with an abnormal US appearance, CAH should be suspected (case 1; Table 1 and Figure 3).…”

The investigation of fetal adrenal gland sizes in the pregnancies complicated with the intrauterine growth restriction

“…[9,13,14] Besides, the impacts of hyperinsulinemia in the presence of maternal diabetes on the function and morphology of adrenal gland have been assessed in various studies. [3,15] The impacts of intrauterine growth restriction due to placental dysfunction on the fetal adrenal gland were investigated in the animal models. These studies found increases in the hormone synthesis of fetal adrenal gland, the weight of adrenal gland and plasma cortisol levels.…”

The relationship of fetal adrenal gland size with fetal liver length and fetal abdominal wall fat thickness in mothers with and without gestational diabetes

“…Additionally, some studies have examined the size of the fetal adrenal gland as another criterion in gestational diabetes (10). The fetal adrenal gland is a speci c endocrine organ with an active role during fetal development that produces large amounts of steroids for estrogen biosynthesis.…”