Abstract
Gestational diabetes mellitus (GDM) is a common pregnancy complication. Its etiology remains incompletely understood. Studies in recent years suggest that fetal sex may affect maternal metabolic milieu during pregnancy. We sought to assess whether there is fetal sex dimorphism in the risk factors of GDM. In a prospective pregnancy cohort in Shanghai, China, we studied 2,435 singleton pregnant women without pre-existing diabetes. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG)' criteria. Log-binomial models were applied to obtain the adjusted relative risk (aRR). A total of 380 (15.6%) women developed GDM. Family history of diabetes was associated with an increased risk of GDM in women bearing a female fetus [aRR 1.74 (1.27–2.40), p < 0.001], but not in women bearing a male fetus (p = 0.68) (test for interaction, p = 0.03). Alcohol drinking was associated with an increased risk of GDM in women bearing a male fetus only (p = 0.023), although the test for interaction did not reach statistical significance (p = 0.055). In conclusion, family history of diabetes was associated with an increased risk of GDM in women bearing a female fetus only in this Chinese pregnancy cohort. There may be a need to consider fetal sex dimorphism in evaluating the risk factors of GDM.
Highlights
Gestational diabetes mellitus (GDM) is a common pregnancy complication characterized by impaired glucose tolerance with first-time recognition during pregnancy [1]
All other risk factors were similar in women bearing a male vs. a female fetus
In the whole study cohort, faster gestational weight gain (GWG) in early pregnancy was associated with an increased risk of GDM (Table 2)
Summary
Gestational diabetes mellitus (GDM) is a common pregnancy complication characterized by impaired glucose tolerance with first-time recognition during pregnancy [1]. Major risk factors of GDM include pre-pregnancy overweight and obesity, excessive gestational weight gain (GWG) during early/mid pregnancy, certain ethnicity (e.g., Asian), advanced maternal age, multiple pregnancy, history of GDM and family history of diabetes [2,3,4,5]. It has been recognized in recent years that fetal sex may influence glucose metabolism in the mother during pregnancy. Among women with GDM, those who carried a girl have about 6% higher relative risk of developing type 2 diabetes in the future [9, 10]. We sought to test this hypothesis in a prospective pregnancy cohort
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