J Clin Endocrinol Metab. 2022 Oct 17:dgac602. doi: 10.1210/clinem/dgac602. Online ahead of print.
ABSTRACT
CONTEXT: Gestational diabetes (GDM) imposes long-term adverse health effects on the mother and fetus. The role of magnetic resonance imaging (MRI) during early gestation in GDM has not been well-studied.
OBJECTIVE: To investigate the role of quantitative MRI measurements of placental volume and perfusion, with distribution of maternal adiposity, during early-gestation in GDM.
DESIGN: ∼200 pregnant women recruited in the first trimester were followed temporally through pregnancy until parturition.
SETTING: Outpatient antenatal obstetrics clinics.
INTERVENTIONS: Two placental MRI scans were prospectively performed at 14-16 weeks and 19-24 weeks gestational age (GA). Placental volume and blood flow (PBF) were calculated from placental regions of interest; maternal adiposity distribution was assessed by subcutaneous fat area ratio (SFAR) and visceral fat area ratio (VFAR). Statistical comparisons were performed using the two-tailed t-test. Predictive logistic regression modeling was evaluated by area under the curves (AUC).
RESULTS: Of a total 186 subjects, 21 subjects (11.3%) developed GDM. VFAR was higher in GDM versus the control group, at both time points (p < 0.001 each). Placental volume was greater in GDM versus the control group at 19-24 weeks GA (p = 0.01). Combining VFAR, placental volume and perfusion, improved the AUCs to 0.83 at 14-16 weeks (PPV = 0.77, NPV = 0.83), and 0.81 at 19-24 weeks GA (PPV = 0.73, NPV = 0.86).
CONCLUSION: A combination of MRI-based placental volume, perfusion and visceral adiposity during early pregnancy demonstrates significant changes in GDM and provides a proof of concept for predicting the subsequent development of GDM.
PMID:36251771 | DOI:10.1210/clinem/dgac602
