Placental perfusion, maternal visceral adiposity may predict gestational diabetes

Key Takeaways:

• Women who developed gestational diabetes had more visceral fat in the second trimester and greater placental volume at 19 to 24 weeks’ gestation.
• MRI imaging may help predict gestational diabetes.

MRI-determined placental volume, perfusion and visceral adiposity in early pregnancy were significantly associated with gestational diabetes, according to a prospective study published in The Journal of Clinical Endocrinology & Metabolism.

“MRI can be used to assess placental volume and function early in gestation in predicting subsequent development of gestational diabetes mellitus,” Sherin U. Devaskar, MD, distinguished professor of pediatrics at the David Geffen School of Medicine at UCLA, told Healio. “In addition to the current standard testing modalities, the health of the placenta can be assessed in vivo early in gestation.”

Researchers followed 186 women through their pregnancy until childbirth. All women were in their first trimester and were recruited from established UCLA outpatient antenatal obstetrics clinics between February 2017 and February 2019. Researchers performed two placental MRI scans at 14 to 16 weeks and 19 to 24 weeks gestational age. Researchers calculated placental volume and blood flow from placental regions of interest, and maternal adiposity was assessed by subcutaneous fat area ratio and visceral fat area ratio.

Of the cohort, 21 women developed gestational diabetes (11.3%; mean age, 24.9 years). Among women with gestational diabetes, visceral fat area ratio was higher compared with women in the control group at both time points (P < .001 for both). Women with gestational diabetes also had greater placental volume compared with women in the control group at 19 to 24 weeks gestational age (P = .01).

When combining visceral fat area ratio and placental volume and perfusion, researchers observed an improved area under the curve of 0.83 at 14 to 16 weeks and 0.81 at 19 to 24 weeks gestational age.

According to the researchers, these findings correlate with the understanding of the association between visceral adiposity and placental perfusion during early pregnancy in the setting of gestational diabetes. In addition, the researchers noted that MRI measurements may serve an adjunct to circulating biomarkers for predicting which women might develop gestational diabetes.

“It would be important to see if such a change in placental function persists into late gestation as well in gestational diabetes mellitus,” Devaskar said. “In addition, these findings should be confirmed in other studies with a larger sample size.”

For more information:

Sherin U. Devaskar, MD, can be reached at sdevaskar@mednet.ucla.edu.