Does a First-Degree Family History of Diabetes Impact Placental Maternal and Fetal Vascular Circulation and Inflammatory Response?

• Published in: The journal of clinical endocrinology and metabolism Vol. 102; no. 9; pp. 3375 - 3380
• Main Authors: Shargorodsky, Marina, Kovo, Michal, Schraiber, Letizia, Bar, Jacob
• Format: Journal Article
• Language: English
• Published: Washington, DC Endocrine Society 01.09.2017; Copyright Oxford University Press; Oxford University Press
• Subjects: Adult; Biopsy, Needle; Blood Glucose - analysis; Body mass index; Case-Control Studies; Cohort Studies; Diabetes; Diabetes mellitus; Diabetes Mellitus - diagnosis; Diabetes Mellitus - genetics; Diabetes, Gestational - diagnosis; Diabetes, Gestational - epidemiology; Female; Fetuses; Genetic Predisposition to Disease - epidemiology; Gestational Age; Health risk assessment; Heritability; Humans; Hyperinsulinemia; Immunohistochemistry; Incidence; Inflammation; Inflammation - epidemiology; Inflammation - pathology; Linear Models; Multivariate Analysis; Perfusion; Placenta; Placenta Diseases - pathology; Placental Circulation - physiology; Pregnancy; Pregnancy Outcome; Prenatal Diagnosis; Risk Assessment
• ISSN: 0021-972X; 1945-7197; 1945-7197
• DOI: 10.1210/jc.2017-00434

ContextHeritability of diabetes is associated with hyperinsulinemia, impaired endothelial function, and inflammatory up-regulation. However, no studies have examined whether a family history of diabetes (FHD) effects placental vascular circulation.ObjectiveThe current study was designed to investigate the impact of a first-degree FHD on placental vascular circulation and inflammatory lesions.DesignObservational cohort study.SettingPregnant women who gave birth at Edith Wolfson Medical Center.PatientsThree hundred thirty-nine pregnant women were divided into two groups according to presence of FHD: group 1 included 225 subjects without FHD, and group 2 included 114 subjects with FHD.InterventionPlacental histopathological examination.Main Outcome MeasuresPlacental vascular supply abnormalities of maternal and fetal origin.ResultsMaternal vascular supply (MVS) abnormalities of the placenta were significantly higher in subjects with FHD, compared with subjects without FHD (P < 0.005). Fetal vascular supply abnormalities, as well as maternal and fetal inflammatory response did not differ significantly between groups. In the general linear modeling analysis, FHD was an independent and significant predictor of MVS abnormalities and more than doubled the risk of this outcome. Gestational diabetes mellitus (GDM) incidence was significantly higher in subjects with FHD (P < 0.0001). Significant by-group differences in GDM persisted even after adjustment for age and body mass index. Although incidence of gestational hypertensive disorders was significantly higher in individuals with FHD, after adjustment FHD did not significantly predict this outcome.ConclusionsA first-degree FHD is significantly and independently associated with an increased rate of maternal vascular perfusion abnormalities and risk of GDM.We studied the impact of a first-degree family history of diabetes (FHD) on placental circulation. We found that FHD was independently associated with maternal vascular perfusion abnormalities.