Clinical and ultrasound features of placental maturation in pre-gestational diabetic pregnancy

• Published in: Early human development Vol. 88; no. 10; pp. 817 - 821
• Main Authors: Higgins, Mary F., Russell, Noirin M., Mooney, Eoghan E., McAuliffe, Fionnuala M.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.10.2012; Elsevier
• Subjects: Adult; Advanced Basic Science; Biological and medical sciences; Delayed villous maturation; Diabetes; Embryology: invertebrates and vertebrates. Teratology; Female; Fundamental and applied biological sciences. Psychology; Humans; Incidence; Neonatal and Perinatal Medicine; Placenta; Placenta - diagnostic imaging; Placenta - physiopathology; Placenta Diseases - diagnostic imaging; Placenta Diseases - epidemiology; Placenta Diseases - pathology; Placentation; Pregnancy; Pregnancy in Diabetics - diagnosis; Prospective Studies; Ultrasonography; Pregnancy; Delayed villous maturation; Placenta; Diabetes; Endocrinopathy; Human; Fetal membrane; Diabetes mellitus; Ultrasound
• ISSN: 0378-3782; 1872-6232; 1872-6232
• DOI: 10.1016/j.earlhumdev.2012.06.001

Pre-gestational diabetes (PGDM) is a significant cause of neonatal morbidity and mortality. Delayed villous maturation (DVM) is a placental diagnosis with increased risk of perinatal mortality. This study aimed to prospectively look at the incidence of DVM in a PGDM population compared to non-diabetic controls. Additionally, we analysed antenatal ultrasound and clinical markers for DVM in the diabetic population. This is a prospective study. Placentae of women with non-diabetic and PGDM pregnancies underwent detailed blinded histo-pathological examination. Clinical data, including birth weight, peri-natal outcome, and, in PGDM group, glycaemic control and ultrasound findings, were obtained. 77 non-diabetic women and 74 PGDM women consented to the study. The incidence of DVM in the PGDM group was higher than in the non-diabetic group (21/74 (28.4%) vs. 11/77 (14.3%) p=0.02; RR 1.98). In the PGDM group clinical and ultrasound markers were compared between the DVM group (n=21) and the non‐DVM group (n=53). There was no difference in perinatal outcome nor glycaemic control between these two groups. DVM, a placental finding with an increased risk of perinatal mortality, is increased in PGDM population compared to non-diabetic controls. No association was found with maternal glycaemic control. The presence of placental DVM was not associated with antenatal ultrasound parameters nor clinical perinatal outcome.