In women with gestational diabetes mellitus factors influencing growth have a larger effect on placental weight than on birth weight

Ramos, Analía; Caimari, Francisca; Pujol, Isabel; García‐Patterson, Apolonia; Ginovart, Gemma; Adelantado, Juan M.; Corcoy, Rosa

doi:10.1016/j.ejogrb.2016.04.022

Cited by 13 publications

(8 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There have been studies on placentas of diabetic women which have reported large babies and higher placental weights. [11][12][13][14][15] In contrast to that, we encountered more number of small placentas which belonged to small to normally grown babies and was comparable with Edu et al 16 Risk of foetal loss is increased in diabetic pregnancy irrespective of glycemic control. 17 Similarly, incidence of intrauterine death was higher in women in both the groups.…”

Section: Discussionsupporting

confidence: 84%

Gestational hyperglycemia on diet and medication: impact on placental pathology and pregnancy outcomes

Natarajan

Umamaheswari

2019

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: To evaluate the placental morphology and perinatal outcome in patients with gestational hyperglycemia on diet and medication.Methods: Placental examinations performed at the Department of Pathology between August 2016 to August 2018 were retrospectively reviewed. Of the received 140 placentas, 35 of gestational diabetes (GDM) and pre gestational diabetes were identified and segregated into hyperglycemia on diet and on medication. The clinical details, placental findings and perinatal outcome of patients in both the groups (gestational hyperglycemia on diet and medication) were collected and analyzed.Results: Among the 35 cases, there were 24 cases of mild gestational hyperglycemia controlled with diet and 11 cases of hyperglycemia on medication (oral hypoglycemic drugs ± insulin).Most of the placentae in both the groups weighed less than tenth centile. The cord abnormalities such as hyper coiling, velamentous /marginal insertion and furcate cord were observed more in women with GDM on diet. There was no significant gross placental lesion in those on medication. Placental histological features most consistently associated with both the groups include, disturbances of villous maturation (DVM), Derangements in uteroplacental / foetoplacental circulation and villous capillary lesions. Small for gestational age and intrauterine foetal death were found in both the groups, but more commonly in patients with hyperglycemia on medication.Conclusions: Villous maturation defects, uteroplacental / foetoplacental malperfusion are the essential placental changes which can result in adverse perinatal outcomes in women with hyperglycemia irrespective of the diabetic control.

show abstract

Section: Discussionsupporting

confidence: 84%

Gestational hyperglycemia on diet and medication: impact on placental pathology and pregnancy outcomes

Natarajan

Umamaheswari

2019

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

show abstract

“…Others have evaluated birth weight and placental weight associations in gestational DM and found significant associations between maternal hemoglobin A1C, history of glucose intolerance and higher placental weight in FDM pregnancies ( 21 ). Increased angiogenesis, with increased capillary leakiness have been described in the type 1 diabetic human placenta and may be related to increased levels of placental vascular endothelial growth factor ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

Depressed left and right ventricular cardiac output in fetuses of diabetic mothers

et al. 2018

View full text Add to dashboard Cite

IntroductionWe compared right and left ventricular cardiac output (RVCO and LVCO) in fetuses of diabetic mothers (FDM) with a large normal cohort.MethodsWe prospectively enrolled 264 normal fetuses and 30 FDM. Fetal CO parameters such as semilunar valve velocity time integrals (AVVTI, PVVTI), ventricular outflow diameters (LVOTD, RVOTD) and stroke volumes (AVSV, PVSV) were measured, and LVCO and RVCO were calculated. These were normalized using non-linear regression to estimated fetal weight (EFW) to provide means and standard deviations. Among FDMs, mean Z scores and 95% confidence limits (CL) were calculated and compared to zero.ResultsLVCO, RVCO and parameters they were calculated from, increased predictably and non-linearly with increasing EFW. In FDM, LVCO was depressed (mean Z −1.679, 95% CL −2.404, −0.955, P < 0.001), and AVVTI, LVOTD and AVSV were significantly lower than normal. Similarly, RVCO (mean Z = −1.119, CL −1.839, −0.400, P = 0.003), RVOTD (mean −2.085, CL −3.077, −1.093, P < 0.001) and PVSV (mean −1.184, CL −1.921, −0.446, P = 0.003) were lower than normal, however, PVVTI was not different (mean Z 0.078, CL −0.552, +0.707, P = 0.803).ConclusionNormal biventricular stroke volumes and outputs follow a non-linear regression with EFW. FDM have significantly lower right and left heart stroke volumes and outputs for weight than do normal fetuses.

show abstract

“…No differences in placental leptin were found by gender or delivery method. We performed univariate regression for already known factors that affect placental weight [22,23] (i. e., gestational age, pregestational BMI, gestational weight gain), and included maternal serum leptin levels, placental leptin, and LEPR expression (table 1S). In the multiple regression model, we only included predictors that were significant in the univariate analysis (Model 1) and the ones that remained significant after model 1 (Model 2).…”

Section: Placental Leptinmentioning

confidence: 99%

“…Moreover, placental leptin has been proposed as a signal of placental insufficiency [27]. As placental abnormalities and uteroplacental malperfusion are associated with SGA [22,23] it is plausible that placental leptin increase in SGA responds to certain degree of placental insufficiency.…”

Section: Sga Mothers (N = 20)mentioning

confidence: 99%

Leptin and its Receptors in Human Placenta of Small, Adequate, and Large for Gestational Age Newborns

Lazo-de-la-Vega-Monroy

Gonzalez-Dominguez

Zaina

et al. 2017

Horm Metab Res

View full text Add to dashboard Cite

Alterations in birth weight impact postnatal outcome and adult metabolic health. Therefore, fetal growth regulation is crucial for preventing chronic metabolic diseases. Leptin has been suggested to play an important role in placental and fetal growth, albeit its specific mechanisms of action have not been elucidated. The aim of this study was to analyze leptin concentrations in placenta, cord blood, and maternal blood of SGA, AGA, and LGA (small, adequate and large for gestational age, respectively) newborns, as well as placental leptin receptor (LEPRa and LEPRb) protein expression. We performed a cross-sectional comparative study in 3 groups of healthy mothers and their term newborns at delivery (SGA, AGA, and LGA, n=20 per group). Placental, maternal blood, and cord blood leptin content were measured by ELISA. Placental LEPRa and LEPRb protein expression were determined by Western Blot. Maternal leptin concentrations correlated positively with maternal weight before and at the end of gestation, without differences between groups. Cord leptin is higher in LGA and lower in SGA, whereas placental leptin is higher in SGA. Placental leptin was inversely correlated with placental weight, independently from maternal weight and gestational age. Both LEPRa and LEPRb expression are lower in SGA, while LEPRa positively correlated with placental weight and birthweight. The current findings indicate that placental leptin and its receptors are differentially expressed in SGA, AGA, and LGA newborns. We suggest that placental leptin and LEPR protein expression may influence placental growth and thus, birth weight.

show abstract

In women with gestational diabetes mellitus factors influencing growth have a larger effect on placental weight than on birth weight

Cited by 13 publications

References 36 publications

Gestational hyperglycemia on diet and medication: impact on placental pathology and pregnancy outcomes

Gestational hyperglycemia on diet and medication: impact on placental pathology and pregnancy outcomes

Depressed left and right ventricular cardiac output in fetuses of diabetic mothers

Leptin and its Receptors in Human Placenta of Small, Adequate, and Large for Gestational Age Newborns

Contact Info

Product

Resources

About