Tekin Sinem, Ocal Aydın, Guleroglu Filiz Yarsilikal, Ozgün Selcuk Cagseli Göksu, Eyisoy Omer Gökhan, Ocal Emine Ufuk Büyükkaya, Cetin Ali
Department of Obstetrics and Gynecology, Haseki Training and Research Hospital Affiliated With the University of Health Sciences, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Yozgat City Hospital, Istanbul, Turkey.
J Clin Ultrasound. 2025 Sep;53(7):1554-1564. doi: 10.1002/jcu.24100. Epub 2025 Jun 2.
The aim of this study was to compare ultrasonographic measurements of selected fetal organs in diabetic pregnancies with non-diabetic pregnancies and to evaluate their potential as markers of fetal metabolic changes.
This prospective comparative observational study included 143 singleton pregnancies (73 with DM and 70 with normal glucose tolerance) between 20 and 39 weeks of gestation. Ultrasonographic measurements of fetal liver length, pancreas size, adrenal gland size, thymus size, and placental thickness were obtained. Measurements were standardized as Z-scores and correlated with maternal glycemic parameters.
Fetal liver length (50.20 ± 12.44 vs. 37.24 ± 6.25 mm, p < 0.0001), pancreas circumference (10.62 ± 3.04 vs. 8.10 ± 2.06 cm, p < 0.0001), adrenal gland circumference (5. 58 ± 1.52 vs. 4.81 ± 1.03 cm, p = 0.0004), and placental thickness (45.78 ± 10.58 vs. 36.45 ± 5.48 mm, p < 0.0001) were significantly increased in diabetic pregnancies. Organ measurements were significantly positively correlated with HbA1c and fasting glucose levels. Multiple logistic regression analysis identified fetal liver length as the strongest independent predictor of maternal diabetes (OR: 11.797, 95% CI: 2.875-48.405, p = 0.001).
Maternal diabetes is associated with selective enlargement of fetal metabolic organs. These ultrasonographic findings may serve as valuable non-invasive markers to identify fetuses at risk of in utero metabolic alterations in pregnancies complicated by diabetes mellitus.
本研究旨在比较糖尿病妊娠与非糖尿病妊娠中选定胎儿器官的超声测量值，并评估其作为胎儿代谢变化标志物的潜力。
这项前瞻性比较观察性研究纳入了143例单胎妊娠（73例患有糖尿病，70例糖耐量正常），妊娠周数在20至39周之间。获取了胎儿肝脏长度、胰腺大小、肾上腺大小、胸腺大小和胎盘厚度的超声测量值。测量值标准化为Z分数，并与母亲血糖参数相关联。
糖尿病妊娠中胎儿肝脏长度（50.20±12.44 vs. 37.24±6.25 mm，p<0.0001）、胰腺周长（10.62±3.04 vs. 8.10±2.06 cm，p<0.0001）、肾上腺周长（5.58±1.52 vs. 4.81±1.03 cm，p = 0.0004）和胎盘厚度（45.78±10.58 vs. 36.45±5.48 mm，p<0.0001）均显著增加。器官测量值与糖化血红蛋白和空腹血糖水平显著正相关。多因素逻辑回归分析确定胎儿肝脏长度是母亲患糖尿病的最强独立预测因素（OR：11.797，95%CI：2.875 - 48.405，p = 0.001）。
母亲患糖尿病与胎儿代谢器官的选择性增大有关。这些超声检查结果可作为有价值的非侵入性标志物，用于识别糖尿病合并妊娠中存在子宫内代谢改变风险的胎儿。
