Hong, Jesrine and Crawford, Kylie and Cavanagh, Erika and Clifton, Vicki and Costa, Fabricio da Silva and Perkins, Anthony V. and Kumar, Sailesh (2025) 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, 160. pp. 51-59. ISSN 0143-4004, DOI https://doi.org/10.1016/j.placenta.2024.12.025.
Full text not available from this repository.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.
| Item Type: | Article |
|---|---|
| Funders: | National Health & Medical Research Council (NHMRC) of Australia, Mater Foundation |
| Uncontrolled Keywords: | Diabetes mellitus; Gestational diabetes; Small for gestational age; Preterm birth; Neonatal morbidity; Stillbirth; Neonatal mortality |
| Subjects: | R Medicine > RG Gynecology and obstetrics |
| Divisions: | Faculty of Medicine > Obstetrics & Gynaecology Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 13 Mar 2025 05:24 |
| Last Modified: | 14 Mar 2025 01:09 |
| URI: | http://eprints.um.edu.my/id/eprint/47732 |
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