Gestational diabetes mellitus in patients undergoing assisted reproductive techniques or conceiving spontaneously: an analysis on maternal and foetal outcomes

• Published in: Journal of endocrinological investigation Vol. 47; no. 7; pp. 1797 - 1803
• Main Authors: Burlina, S., Dalfrà, M. G., Marchetto, A., Lapolla, A.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-07-2024; Springer Nature B.V
• Subjects: Adult; Birth weight; Blood Glucose - analysis; Blood Glucose - metabolism; Case-Control Studies; Cesarean section; Cholesterol; Diabetes mellitus; Diabetes, Gestational - diagnosis; Diabetes, Gestational - epidemiology; Diagnosis; Endocrinology; Female; Fertilization - physiology; Gestational diabetes; Glucose tolerance; Glucose Tolerance Test; Humans; Infant, Newborn; Internal Medicine; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolism; Neonates; Original Article; Pregnancy; Pregnancy complications; Pregnancy Outcome - epidemiology; Reproduction; Reproductive Techniques, Assisted - statistics & numerical data; Retrospective Studies; Statistical analysis; Triglycerides; Pregnancy; Maternal outcomes; Medical-assisted procreation techniques; Gestational diabetes; Foetal outcomes
• ISSN: 1720-8386; 0391-4097; 1720-8386
• DOI: 10.1007/s40618-023-02282-2

Purpose
With the rise of medically assisted reproductive techniques (ART) the number of pregnancies complicated by gestational diabetes mellitus (GDM) has increased. The aim of this study was to evaluate retrospectively the outcomes of pregnancies complicated by GDM who conceive trough ART (cases) compared to those who conceived spontaneously (controls).
Methods
In 670 women with GDM, 229 cases and 441 controls, followed by the Diabetology of Padua, between 2010-2022, clinical-metabolic maternal characteristics and maternal-foetal outcomes were evaluated.
Results
As for the maternal clinical-metabolic characteristics, plasma glucose levels at 60’ and 120’ under oral glucose tolerance test (OGTT) at time of diagnosis were significantly higher in cases (177.4 ± 31.1 vs 170.9 ± 34.1 mg/dl,
p
 = 0.016; 151.5 ± 32.2 vs 144.0 ± 33.4 mg/dl,
p
 = 0.005 respectively). Furthermore, at diagnosis, cases show higher levels of total cholesterol (257 ± 53 mg/dl vs 246 ± 52 mg/dl;
p
 = 0.012) and triglycerides (199.8 ± 83.2 mg/dl vs 184.9 ± 71.3 mg/dl;
p
 = 0.02) compared to controls. As for maternal outcomes, thyroid disfunction, was recorded in a higher percentage in case (21.4% vs 14.3%;
p
 = 0.008), as well as, the frequency of cesarean section (50.3% vs 41.2%;
p
 = 0.038) and twin pregnancies (16.2% vs 2.5%;
p
 < 0.001). As for neonatal outcomes, there were no statistically significant differences, except for the birth weight of the second twin, which was significantly lower in cases (2268 ± 536 vs 2822 ± 297 g;
p
 = 0.002). No other significant differences were found.
Conclusion
This study showed no meaningful differences in the outcomes of GDM pregnancies who were conceived with ART compared to that arose spontaneously as the patients were promptly diagnosed and treated.