Journal article
The relationship between abnormal fetoplacental Dopplers, angiogenic markers of placental dysfunction and adverse perinatal outcomes in diabetic pregnancies with small fetuses – A prospective study
Placenta , Vol.160, pp.51-59
2025
Abstract
Introduction
The aim of this study was to evaluate differences in circulating maternal placental biomarkers and fetoplacental Dopplers in women with diabetes mellitus in pregnancy (DIP) with prenatally identified small fetuses (defined as <20th centile for gestational age) compared to women with small fetuses without DIP.
Methods
This was a prospective cohort study of women with DIP with small infants compared to a non-diabetic cohort with similarly small fetuses. Multivariable logistic regression was used to evaluate the effect of DIP on placental biomarkers, fetoplacental Dopplers, and adverse perinatal outcomes.
Results
There were 447 pregnancies in this study – 117 (26.2 %) had DIP and 330 (73.8 %) did not have diabetes. Of the DIP cohort, 57 (48.7 %) had early-onset and 27 (23.1 %) had late-onset FGR. Higher rates of low PlGF levels<100 ng/L (42.1 % vs. 25.7 %,p = 0.002), high sFlt-1/PlGF ratio (39.6 % vs. 25.4 %,p = 0.006), low MCA PI < 5th centile at recruitment (18.8 % vs. 7.6 %,p < 0.001, OR 2.37 95%CI 1.25, 4.46,p = 0.008), abnormal UA Doppler before delivery (OR 1.63 95%CI 1.00, 2.66,p = 0.048) were seen in the DIP cohort. DIP was associated with higher rates of emergency cesarean section (43.6 % vs. 26.7 %,p = 0.001) and lower birthweight (2300 (1558, 2610g) vs. 2447 (2050, 2690g),p = 0.003). The odds of early FGR (OR 1.90 95%CI 1.20, 2.98,p = 0.006), PTB<37 weeks (OR 1.66 95%CI 1.02, 2.70,p = 0.039), PTB<34 weeks’ gestation (OR 3.00 95%CI 1.51, 5.96,p = 0.002), composite non-neurological neonatal morbidity (OR 1.86 95%CI 1.04, 3.33,p = 0.037), and hypoglycemia (OR 3.69 95%CI 1.59, 8.54,p = 0.002) were significantly higher in DIP.
Conclusions
DIP is associated with increased risks of early-onset FGR, PTB, composite severe non-neurological neonatal morbidity, and neonatal hypoglycemia in women with small infants. DIP was significantly associated with increased odds of MCA PI < 5th centile at diagnosis and abnormal UA Doppler before birth.
Details
- Title
- The relationship between abnormal fetoplacental Dopplers, angiogenic markers of placental dysfunction and adverse perinatal outcomes in diabetic pregnancies with small fetuses – A prospective study
- Authors
- Jesrine Hong - University of QueenslandKylie Crawford - University of QueenslandErika Cavanagh - University of QueenslandVicki Clifton - University of QueenslandFabricio da Silva Costa - Griffith UniversityAnthony V. Perkins - University of the Sunshine Coast, Queensland, School of HealthSailesh Kumar (Corresponding Author) - University of Queensland
- Publication details
- Placenta , Vol.160, pp.51-59
- Publisher
- Elsevier Ltd
- Date published
- 2025
- DOI
- 10.1016/j.placenta.2024.12.025
- ISSN
- 1532-3102
- Data Availability
- Data used to produce the results in this article will be available to any researcher provided appropriate ethics approval, inter-institutional data sharing agreements and other regulatory requirements are in place.
- Grant note
- National Health and Medical Research Council and Mater Foundation.
- Organisation Unit
- School of Health
- Language
- English
- Record Identifier
- 991091101602621
- Output Type
- Journal article
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- Domestic collaboration
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- Web Of Science research areas
- Developmental Biology
- Obstetrics & Gynecology
- Reproductive Biology
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