Fetal Sex, Need for Insulin, and Perinatal Outcomes in Gestational Diabetes Mellitus: An Observational Cohort Study

Giannubilo, Stefano Raffaele; Pasculli, Angela; Ballatori, Chiara; Biagini, Alessandra; Ciavattini, Andrea

doi:10.1016/j.clinthera.2018.02.015

Cited by 18 publications

(17 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Across multiple species, including mice, bovine, birds, and humans, male embryos grow faster than female embryos and exhibit concordant differences in nutrient utilization and energy consumption [158][159][160][161][162][163]. In humans, pyruvate and glucose uptake, as well as lactate production, are significantly higher in male embryos [158], and the presence of male fetuses has been associated with elevated maternal fasting plasma glucose [164,165]. In cows, a high concentration of glucose selectively blocks development of female embryos during the morula to blastocyst transition [166][167][168].…”

Section: Sex Differences In Metabolismmentioning

confidence: 99%

Sex differences in cancer mechanisms

et al. 2020

View full text Add to dashboard Cite

We now know that cancer is many different diseases, with great variation even within a single histological subtype. With the current emphasis on developing personalized approaches to cancer treatment, it is astonishing that we have not yet systematically incorporated the biology of sex differences into our paradigms for laboratory and clinical cancer research. While some sex differences in cancer arise through the actions of circulating sex hormones, other sex differences are independent of estrogen, testosterone, or progesterone levels. Instead, these differences are the result of sexual differentiation, a process that involves genetic and epigenetic mechanisms, in addition to acute sex hormone actions. Sexual differentiation begins with fertilization and continues beyond menopause. It affects virtually every body system, resulting in marked sex differences in such areas as growth, lifespan, metabolism, and immunity, all of which can impact on cancer progression, treatment response, and survival. These organismal level differences have correlates at the cellular level, and thus, males and females can fundamentally differ in their protections and vulnerabilities to cancer, from cellular transformation through all stages of progression, spread, and response to treatment. Our goal in this review is to cover some of the robust sex differences that exist in core cancer pathways and to make the case for inclusion of sex as a biological variable in all laboratory and clinical cancer research. We finish with a discussion of lab-and clinic-based experimental design that should be used when testing whether sex matters and the appropriate statistical models to apply in data analysis for rigorous evaluations of potential sex effects. It is our goal to facilitate the evaluation of sex differences in cancer in order to improve outcomes for all patients.

show abstract

Section: Sex Differences In Metabolismmentioning

confidence: 99%

Sex differences in cancer mechanisms

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Recently, it was shown that fetal sex might influence maternal plasma glucose levels. The presence of male fetuses was independently associated with elevated maternal fasting plasma glucose and lower basal β-cell function (73, 74).…”

Section: Sex Differences In Nutrition and Metabolismmentioning

confidence: 99%

Sex Differences in Nutrition, Growth, and Metabolism in Preterm Infants

Alur

2019

Front. Pediatr.

106

View full text Add to dashboard Cite

Biological differences between the sexes are apparent even from the early part of the pregnancy. The crown-rump length is larger in male fetuses compared to females in the first trimester. Placentae of male and female fetuses have different protein and gene expressions, especially in adverse conditions. Even within the intrauterine milieu, the same extracellular micro RNA may show upregulation in females and downregulation in male fetuses. There appears to be a natural survival advantage for females. Maternal glucocorticoids (GC) play an important role in fetal growth and organ maturation. However, excess glucocorticoids can not only affect growth but the response may be sex-specific and probably mediated through glucocorticoid receptors (GR) in the placenta. Mild pre-eclampsia and asthma are associated with normal growth pattern in males, but in female fetuses, they are associated with a slowing of growth rate without causing IUGR probably as an adaptive response for future adverse events. Thus, female fetuses survive while male fetuses exhibit IUGR, preterm delivery and even death in the face of another adverse event. It is thought that the maternal diet may not influence growth but may influence the programming for adult disease. There is growing evidence that maternal pre-pregnancy overweight or obesity status is directly associated with a higher risk of obesity in a male child, but not in a female child, at 1 year of age. It is observed that exposure to gestational diabetes is a risk factor for childhood overweight in boys but not in girls. It is fascinating that male and female fetuses respond differently to the same intrauterine environment, and this suggests a fundamental biological variation most likely at the cellular and molecular level.

show abstract

“…Previous studies on the general obstetric population and GDM pregnancies have shown that mothers carrying male fetuses have lower insulin sensitivity, lower β-cell function and higher BG levels in the OGTT than those carrying female fetuses. 7,17 Although the mechanism is unclear, one possibility is that fetal sex may impact maternal circulating hormones and proteins involved in β-cell compensation. 26 In the present study, there were no differences in the BG levels at any of the time points of the 75 g-OGTT in relation to fetal sex in the NGT pregnancies.…”

Section: Discussionmentioning

confidence: 99%

“…Whether a greater effect of sex exists in pregnancies complicated by GDM remains unclear. At present, studies on the effects of sex on outcomes in GDM pregnancies are comparatively few, and their results remain equivocal with regard to different adverse perinatal outcomes. More importantly, the current research lacks analyses of the relationship between maternal glycaemic control and the influences of fetal sex on perinatal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Influence of fetal sex on perinatal outcomes in women with gestational diabetes mellitus

et al. 2019

Diabetes Metabolism Res

View full text Add to dashboard Cite

Background Fetal sex has recently been considered to be related to maternal glucose homeostasis and perinatal outcomes during pregnancy. Here, we investigated the effects of fetal sex on the perinatal outcomes of pregnancies with normal glucose tolerance (NGT) and gestational diabetes mellitus (GDM). Methods This was a retrospective cohort study of 1292 women with NGT and 1155 women with GDM. Pregnant women were divided into four groups according to the maternal glucose level and fetal sex. Logistic regression was used to evaluate the risks for adverse perinatal outcomes among NGT‐males, NGT‐females, GDM‐males and GDM‐females. Results NGT‐males had higher risks for macrosomia and large for gestational age (LGA) than NGT‐females with an odds ratio (OR) of 1.9 (95% CI 1.2‐2.9). Additionally, GDM‐males had higher risks for neonatal infection (OR, 3.0; 95% CI, 1.3‐6.9), acute respiratory disorders (OR, 3.9; 95% CI, 1.1‐13.7) and abnormal neonatal central nervous system development (OR, 3.1; 95% CI, 1.1‐8.4) than GDM‐females. Furthermore, there was a significantly higher risk for newborn infection (OR, 8.5; 95% CI, 1.1‐66.8) in the GDM‐male group than in the GDM‐female group with a glycosylated hemoglobin A1c (HbA1c) level ≥5.5% in the late trimester of pregnancy, which was not observed with an HbA1c level of <5.5%. Conclusions Male fetuses have worse perinatal outcomes than female fetuses, and the difference is more pronounced in GDM pregnancies. More postpartum care is needed for male fetuses, especially in GDM pregnancies with substandard glycemic control.

show abstract

Fetal Sex, Need for Insulin, and Perinatal Outcomes in Gestational Diabetes Mellitus: An Observational Cohort Study

Cited by 18 publications

References 34 publications

Sex differences in cancer mechanisms

Sex differences in cancer mechanisms

Sex Differences in Nutrition, Growth, and Metabolism in Preterm Infants

Influence of fetal sex on perinatal outcomes in women with gestational diabetes mellitus

Contact Info

Product

Resources

About