Arcot Amrita, Gallagher Kelly, Goldstein Jeffery A, Gernand Alison D
The Pennsylvania State University Department of Nutritional Sciences, University Park, PA 16802.
The Pennsylvania State University Ross and Carol Nese College of Nursing, University Park, PA 16802.
medRxiv. 2025 May 16:2025.05.14.25327646. doi: 10.1101/2025.05.14.25327646.
Gestational diabetes mellitus (GDM) is associated with increased placental weight and the presence of placental malperfusion lesions, likely related to high blood glucose. The relationship between high glucose without overt GDM, and placental characteristics is not well understood.
To examine the relationships between glucose challenge test (GCT) concentrations, GDM, and placental characteristics associated with GDM.
We conducted a secondary analysis of medical record data from singleton placentas sent to pathology at Northwestern Memorial Hospital (2011-2022; n=11,585). Data included maternal demographic variables, GCT concentrations, GDM diagnosis, placental weight, and vascular malperfusion lesions (accelerated villous maturation, increased syncytial knots, delayed villous maturation, and increased perivillous fibrin deposition). We classified GCT <140 mg/dL as pass and ≥140 mg/dL as fail. We categorized glucose groups into , , and . We used linear and Poisson regression models to examine the association between GCT concentrations or groups with placental outcomes, adjusting for maternal age, race and ethnicity, parity, gestational age at delivery, and infant sex.
Of placentas sent to pathology, 5% were from pregnancies with GDM and 17% from those who failed the GCT but did not get diagnosed with GDM. Compared to the group, the adjusted mean placental weight was heavier by 13.6 grams [95% CI: 8.8, 18.3] in the and 22.0 grams [13.8, 30.2] in the group. Patients diagnosed with GDM had a 36% [2%, 81%] increased adjusted risk of delayed villous maturation compared to the . The risk of the other lesions was not statistically significantly different between groups.
GDM and high glucose concentrations without GDM were associated with heavier placentas; patients with GDM had a higher risk of delayed villous maturation.
妊娠期糖尿病（GDM）与胎盘重量增加以及胎盘灌注不良病变的存在有关，这可能与高血糖有关。未患明显GDM的高血糖与胎盘特征之间的关系尚不清楚。
研究葡萄糖耐量试验（GCT）浓度、GDM与GDM相关胎盘特征之间的关系。
我们对西北纪念医院（2011 - 2022年；n = 11,585）送检病理的单胎胎盘病历数据进行了二次分析。数据包括产妇人口统计学变量、GCT浓度、GDM诊断、胎盘重量和血管灌注不良病变（绒毛加速成熟、合体结节增加、绒毛成熟延迟和绒毛周围纤维蛋白沉积增加）。我们将GCT <140 mg/dL分类为通过，≥140 mg/dL分类为未通过。我们将葡萄糖组分为[具体分组情况未给出]。我们使用线性和泊松回归模型来研究GCT浓度或组与胎盘结局之间的关联，并对产妇年龄、种族和民族、产次、分娩时的孕周和婴儿性别进行了调整。
在送检病理的胎盘中，5%来自患有GDM的孕妇，17%来自GCT未通过但未被诊断为GDM的孕妇。与[具体分组情况未给出]组相比，[具体分组情况未给出]组调整后的平均胎盘重量重13.6克[95%可信区间：8.8，18.3]，[具体分组情况未给出]组重22.0克[13.8，30.2]。与[具体分组情况未给出]组相比，被诊断为GDM的患者绒毛成熟延迟的调整风险增加了36%[2%，81%]。其他病变的风险在各组之间无统计学显著差异。
GDM和未患GDM的高血糖浓度均与胎盘较重有关；患有GDM的患者绒毛成熟延迟的风险较高。
