Normal foetal kidney volume in offspring of women treated for gestational diabetes

Abstract

Aims The worldwide prevalence of gestational diabetes mellitus (GDM) is increasing. Studies in rodent models indicate that hyperglycaemia during pregnancy alters kidney development, yet few studies have examined if this is so in humans. The objective of this study was to evaluate the association of treated GDM with foetal kidney size. Materials and Methods Participants were recruited from an Australian tertiary hospital, and clinical data were collected from women without GDM and women diagnosed and treated for GDM and their offspring. Participants underwent an obstetric ultrasound at 32‐34 weeks gestation for foetal biometry and foetal kidney volume measurement. Results Sixty‐four non‐GDM and 64 GDM women participated in the study. Thirty percent of GDM women were diagnosed with fasting hyperglycaemia, while 89% had an elevated 2‐hour glucose level. Maternal age, weight and body mass index were similar in women with and without GDM. Estimated foetal weight, foetal kidney dimensions, total foetal kidney volume and birth weight were similar in offspring of women with and without GDM. Conclusions We conclude that a period of mild hyperglycaemia prior to diagnosis of GDM and treatment initiation, which coincides with a period of rapid nephron formation and kidney growth, does not alter kidney size at 32‐34 weeks gestation.

Long-term outcomes and potential mechanisms of offspring exposed to intrauterine hyperglycemia

“…Epidemiologic studies suggested that O-PGDM was associated with strong teratogenic effects on the kidney ( 76 ) and the urinary tract ( 77 ). However, another study concluded that the maternal glucose level was not associated with volume and dimensions of fetal kidney ( 78 ). When children aged 5–18 years were affected, urinary calcium and magnesium excretion was lower in O-T1DM ( 79 ).…”

Programmed Adult Kidney Disease: Importance of Fetal Environment

“…Although it is correlated with high, instead of LBW, is also associated with impairment of both GFR and renal plasma flow ( Abi Khalil et al, 2010 ). The effect of maternal diabetes on fetal kidney volume is not well established ( Hokke et al, 2019 ). In a recent study, instead of nephron number, the total renal and cortical volumes were assessed in newborns.…”