Ravi Retnakaran1, Baiju R Shah1. 1. Lunenfeld-Tanenbaum Research Institute (R.R.), Mt Sinai Hospital, Toronto, Canada M4G 1X5; Leadership Sinai Centre for Diabetes (R.R.), Mt Sinai Hospital, Toronto, Canada M4G 1X5; Division of Endocrinology, University of Toronto (R.R., B.R.S.), Toronto, Canada M4G 2C4; Department of Medicine (B.R.S.), Sunnybrook Health Sciences Centre, Toronto, Canada M4N 3M5; and Institute for Clinical and Evaluative Sciences (B.R.S.), Toronto, Canada M4N 3M5.
Abstract
CONTEXT: It has recently emerged that carrying a male fetus is associated with poorer maternal β-cell function in pregnancy and an increased risk of gestational diabetes mellitus (GDM). β-cell dysfunction is the central pathophysiologic defect underlying both GDM and subsequent postpartum progression to type 2 diabetes mellitus (T2DM). OBJECTIVE: This was a retrospective cohort study that aimed to determine whether fetal sex influences the natural history of maternal risk of diabetes after delivery and in a subsequent pregnancy. SETTING: The study was conducted using population-based administrative databases in Ontario, Canada. PATIENTS: All women with a singleton live-birth first pregnancy between April 2000 and March 2010 (n = 642 987) were included. EXPOSURE: Fetal sex was the exposure of interest (313 280 delivered a girl; 329 707 delivered a boy). MAIN OUTCOME MEASURE: Development of T2DM or a second pregnancy were the main outcome measures. Glucose tolerance in each pregnancy was classified as either GDM or non-GDM. RESULTS: The population was followed for a median of 3.8 years. Carrying a boy yielded a higher risk of GDM in both the first pregnancy (odds ratio [OR] =1.03; 95% confidence interval [CI], 1.0002-1.054) and second pregnancy (OR =1.04, 95% CI, 1.01-1.08). For women with GDM in the first pregnancy, the likelihood of developing T2DM before a second pregnancy was higher if they delivered a girl (OR = 1.07; 95% CI, 1.01-1.12). Recurrence of GDM was not affected by fetal sex (P = .7). However, among women with a non-GDM first pregnancy while carrying a girl, having a boy in their second pregnancy predicted an increased risk of GDM (OR = 1.07, 95% CI, 1.01-1.14). CONCLUSIONS: Fetal sex is a previously unrecognized factor that is associated with maternal diabetic risk both after delivery and in a subsequent pregnancy.
CONTEXT: It has recently emerged that carrying a male fetus is associated with poorer maternal β-cell function in pregnancy and an increased risk of gestational diabetes mellitus (GDM). β-cell dysfunction is the central pathophysiologic defect underlying both GDM and subsequent postpartum progression to type 2 diabetes mellitus (T2DM). OBJECTIVE: This was a retrospective cohort study that aimed to determine whether fetal sex influences the natural history of maternal risk of diabetes after delivery and in a subsequent pregnancy. SETTING: The study was conducted using population-based administrative databases in Ontario, Canada. PATIENTS: All women with a singleton live-birth first pregnancy between April 2000 and March 2010 (n = 642 987) were included. EXPOSURE: Fetal sex was the exposure of interest (313 280 delivered a girl; 329 707 delivered a boy). MAIN OUTCOME MEASURE: Development of T2DM or a second pregnancy were the main outcome measures. Glucose tolerance in each pregnancy was classified as either GDM or non-GDM. RESULTS: The population was followed for a median of 3.8 years. Carrying a boy yielded a higher risk of GDM in both the first pregnancy (odds ratio [OR] =1.03; 95% confidence interval [CI], 1.0002-1.054) and second pregnancy (OR =1.04, 95% CI, 1.01-1.08). For women with GDM in the first pregnancy, the likelihood of developing T2DM before a second pregnancy was higher if they delivered a girl (OR = 1.07; 95% CI, 1.01-1.12). Recurrence of GDM was not affected by fetal sex (P = .7). However, among women with a non-GDM first pregnancy while carrying a girl, having a boy in their second pregnancy predicted an increased risk of GDM (OR = 1.07, 95% CI, 1.01-1.14). CONCLUSIONS: Fetal sex is a previously unrecognized factor that is associated with maternal diabetic risk both after delivery and in a subsequent pregnancy.
Authors: Jennifer M Walsh; Ricardo Segurado; Rhona M Mahony; Michael E Foley; Fionnuala M McAuliffe Journal: PLoS One Date: 2015-09-14 Impact factor: 3.240
Authors: Benjamin G Fisher; Hanne Frederiksen; Anna-Maria Andersson; Anders Juul; Ajay Thankamony; Ken K Ong; David B Dunger; Ieuan A Hughes; Carlo L Acerini Journal: Front Endocrinol (Lausanne) Date: 2018-03-13 Impact factor: 5.555
Authors: See Ling Loy; Ngee Lek; Fabian Yap; Shu E Soh; Natarajan Padmapriya; Kok Hian Tan; Arijit Biswas; George Seow Heong Yeo; Kenneth Kwek; Peter D Gluckman; Keith M Godfrey; Seang Mei Saw; Falk Müller-Riemenschneider; Yap-Seng Chong; Mary Foong-Fong Chong; Jerry Kok Yen Chan Journal: PLoS One Date: 2015-11-16 Impact factor: 3.240