Gestational Diabetes and Intrauterine Growth Restriction

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: closed (31 May 2023) | Viewed by 8740

Special Issue Editors

Gynaecologic Oncology Unit, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
Interests: gynecologic oncology; endometrial cancer; cervical cancer; ovarian cancer; vulvar cancer; cytoreductive surgery
Special Issues, Collections and Topics in MDPI journals
1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, General Hospital of Athens ‘ALEXANDRA’, Lourou and Vasilissis Sofias Ave, 11528 Athens, Greece
Interests: maternal-fetal medicine; intrauterine growth restriction; preeclampsia; preterm birth

Special Issue Information

Dear Colleagues,

Intrauterine growth restriction and gestational diabetes are two of the most common pathologic entities encountered during the antenatal period and account for approximately 10-15% of pregnancies. Gestational diabetes is a significant risk factor that predisposes patients to intrauterine fetal growth restriction through a variety of pathophysiological processes,  examples of which include epigenetic alterations, impaired cholesterol metabolism, placental vasculopathy, etc. Significant advances have been achieved in the last decade; however, research is still needed to elucidate the pathophysiology of both pregnancy complications in order to help achieve optimal maternal and neonatal antenatal outcomes.

In the present issue, we hope that leading experts will share their perspectives on the pathophysiology of gestational diabetes and intrauterine growth restriction and that they will contribute to current knowledge with novel evidence that provides the foundation for further research.

We seek contributions in the form of original research articles, reviews, or shorter perspective articles on all aspects related to the subject. Topics may include but are not limited to epigenetic and genetic modifications, altered protein profiles, ultrasonographic markers, and environmental factors that predispose patients to the occurrence of gestational diabetes and/or intrauterine growth restriction.

Dr. Vasilios Pergialiotis
Prof. Dr. George Daskalakis
Guest Editors

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Keywords

  • gestational diabetes
  • fetal growth restriction
  • IUGR
  • FGR
  • pregnancy complications
  • large for gestational age

Published Papers (4 papers)

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Research

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10 pages, 441 KiB  
Article
Prenatal Diagnosis of Isolated Single Umbilical Artery: Incidence, Risk Factors and Impact on Pregnancy Outcomes
Medicina 2023, 59(6), 1080; https://doi.org/10.3390/medicina59061080 - 03 Jun 2023
Cited by 1 | Viewed by 2031
Abstract
Objectives: To assess the incidence of prenatally diagnosed isolated single umbilical artery (iSUA) and its impact on major pregnancy outcomes, as well as to investigate potential risk factors. Materials and methods: A prospective study of singleton pregnancies, undergoing routine anomaly scans [...] Read more.
Objectives: To assess the incidence of prenatally diagnosed isolated single umbilical artery (iSUA) and its impact on major pregnancy outcomes, as well as to investigate potential risk factors. Materials and methods: A prospective study of singleton pregnancies, undergoing routine anomaly scans at 20+0–24+0 weeks of gestation, was carried out from 2018 to 2022. The effect of sonographically detected iSUA on small-for-gestational-age neonates (SGA) and preterm delivery (PTD) was evaluated using parameterized Student’s t-test, nonparametric Mann–Whitney U test and the chi-square test. Multivariable logistic regression models were implemented to assess the independent association between iSUA and the main outcomes, as well as with potential risk factors, while adjusting for specific confounders. Results: The study population included 6528 singleton pregnancies and the incidence of prenatally diagnosed iSUA was 1.3%. Prenatally diagnosed iSUA had a statistically significant association with both SGA neonates (aOR: 1.909; 95% CI: 1.152–3.163) and PTD (aOR: 1.903; 95% CI: 1.035–3.498), while no association was identified between this sonographic finding and preeclampsia. With regard to risk factors, conception via assisted reproductive technology (ART) was associated with increased risk of iSUA (aOR: 2.234; 95% CI: 1.104–4.523), while no other independent predictor for the development of this anatomical variation was identified. Conclusions: Prenatally diagnosed iSUA seems to be associated with a higher incidence of SGA and PTD and is more common in pregnancies following ART, which constitutes a novel finding. Full article
(This article belongs to the Special Issue Gestational Diabetes and Intrauterine Growth Restriction)
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12 pages, 552 KiB  
Article
Prenatal Exposure to Bisphenol A: Is There an Association between Bisphenol A in Second Trimester Amniotic Fluid and Fetal Growth?
Medicina 2023, 59(5), 882; https://doi.org/10.3390/medicina59050882 - 04 May 2023
Cited by 2 | Viewed by 1584
Abstract
Background and Objectives: Fetal growth abnormalities increase the risk of negative perinatal and long-term outcomes. Bisphenol A (BPA) is a ubiquitous endocrine-disrupting chemical to which humans may be exposed in a number of ways, such as from the environment, via various consumer products, [...] Read more.
Background and Objectives: Fetal growth abnormalities increase the risk of negative perinatal and long-term outcomes. Bisphenol A (BPA) is a ubiquitous endocrine-disrupting chemical to which humans may be exposed in a number of ways, such as from the environment, via various consumer products, and through the individual’s diet. Since the compound possesses estrogen-mimicking properties and exerts epigenetic and genotoxic effects, it has been associated with harmful effects impacting the entire spectrum of human life, including, vitally, the intrauterine period. We investigated the role of maternal exposure to BPA in abnormal fetal growth velocity, both impaired and excessive. Materials and Methods: Amniotic fluid samples were collected from 35 women who underwent amniocentesis early in the second trimester due to medical reasons. Pregnancies were followed until delivery, and birth weights were recorded. The amniotic fluid samples were subsequently divided into three groups based on fetal birth weight, as follows: AGA (appropriate for gestational age), SGA (small for gestational age), and LGA (large for gestational age). Amniotic fluid BPA levels were determined by gas chromatography coupled with mass spectrometry. Results: BPA was detected in 80% (28/35) of our amniotic fluid samples. Median concentration was 281.495 pg/mL and ranged from 108.82 pg/mL to 1605.36 pg/mL. No significant association was observed between the study groups regarding BPA concentration. A significant positive correlation between amniotic fluid BPA concentration and birth weight centile (r = 0.351, p-value = 0.039) was identified. BPA levels were also inversely associated with gestational age in pregnancies at term (between 37 and 41 weeks) (r = −0.365, p-value = 0.031). Conclusions: Our findings suggest that maternal exposure to BPA during the early second trimester of pregnancy can potentially contribute to increased birthweight percentiles and to decreased gestational age in pregnancies at term. Full article
(This article belongs to the Special Issue Gestational Diabetes and Intrauterine Growth Restriction)
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Review

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17 pages, 2610 KiB  
Review
sFLT1, PlGF, the sFLT1/PlGF Ratio and Their Association with Pre-Eclampsia in Twin Pregnancies—A Review of the Literature
Medicina 2023, 59(7), 1232; https://doi.org/10.3390/medicina59071232 - 30 Jun 2023
Cited by 2 | Viewed by 1044
Abstract
Twin pregnancies demonstrate a 2–3-fold higher chance of developing PE compared to singletons, and recent evidence has demonstrated that the sFLT1/PIGF ratio is strongly associated with PE, adverse pregnancy outcomes, as well as imminent deliveries due to PE complications. The primary objective of [...] Read more.
Twin pregnancies demonstrate a 2–3-fold higher chance of developing PE compared to singletons, and recent evidence has demonstrated that the sFLT1/PIGF ratio is strongly associated with PE, adverse pregnancy outcomes, as well as imminent deliveries due to PE complications. The primary objective of this systematic review was to summarise the available data on the levels of sFLT1, PlGF and their ratios in twin pregnancies and to investigate their association with the development of PE, adverse pregnancy outcomes and the timing of the delivery. A systematic search of Ovid Embase, Web of Science, Science Direct, PubMed, Ovid Medline, Google Scholar and CINAHL was carried out. sFLT1 levels and the sFLT1/PIGF ratio appeared higher in twins compared to singleton pregnancies, especially in the third trimester, while PlGF levels appeared higher up until the third trimester, with their values showing no difference or being even lower than in singletons thereafter. The sFLT1/PIGF ratio has been reported to be an independent marker of adverse outcomes related to pre-eclampsia and is associated with the mean time until delivery in an inverse manner. Further research is required in order to establish the optimal sFLT1/PIGF cut-off values and to stratify the risk of adverse outcomes in twin pregnancies. Full article
(This article belongs to the Special Issue Gestational Diabetes and Intrauterine Growth Restriction)
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10 pages, 665 KiB  
Review
Intrauterine Growth Restriction Due to Gestational Diabetes: From Pathophysiology to Diagnosis and Management
Medicina 2023, 59(6), 1139; https://doi.org/10.3390/medicina59061139 - 13 Jun 2023
Cited by 5 | Viewed by 2491
Abstract
Intrauterine growth restriction (IUGR) represents a condition where the fetal weight is less than the 10th percentile for gestational age, or the estimated fetal weight is lower than expected based on gestational age. IUGR can be caused by various factors such as maternal, [...] Read more.
Intrauterine growth restriction (IUGR) represents a condition where the fetal weight is less than the 10th percentile for gestational age, or the estimated fetal weight is lower than expected based on gestational age. IUGR can be caused by various factors such as maternal, placental or fetal factors and can lead to various complications for both the fetus and the mother, including fetal distress, stillbirth, preterm delivery, and maternal hypertension. Women with gestational diabetes are at an increased risk of developing IUGR. This article reviews the different aspects of gestational diabetes in addition to IUGR, the diagnostic methods available for IUGR detection, including ultrasound and Doppler studies, discusses the management strategies for women with IUGR and gestational diabetes and analyzes the importance of early detection and timely intervention to improve pregnancy outcomes. Full article
(This article belongs to the Special Issue Gestational Diabetes and Intrauterine Growth Restriction)
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