Livny Liron, Hallak Mordechai, Naeh Amir, Toledano Yoel, Gabbay-Benziv Rinat, Maor-Sagie Esther
Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, 38100, Hadera, Israel.
Technion-Israel Institute of Technology, Haifa, Israel.
Arch Gynecol Obstet. 2025 Sep 1. doi: 10.1007/s00404-025-08125-0.
Gestational Diabetes Mellitus (GDM) increases the risk of developing Type 2 Diabetes Mellitus (T2DM) postpartum, with emerging evidence suggesting that fetal sex may influence pregnancy outcomes. Some studies suggest that individuals carrying male fetuses experience diminished insulin sensitivity and higher glucose levels during pregnancy. However, it remains unclear whether fetal sex affects the long-term risk of T2DM after pregnancy. This study aimed to investigate the impact of fetal sex on the risk of T2DM up to 5 years postpartum in individuals with GDM.
This retrospective analysis included pregnant individuals diagnosed with GDM, with follow-up data from Meuhedet HMO's computerized pregnancy registry and the Israeli National Diabetes Registry. Inclusion criteria involved singleton pregnancies with GDM diagnosed via abnormal oral glucose tolerance tests (oGTT) or glucose challenge tests (GCT). Exclusion criteria were multifetal pregnancies or prior diabetes diagnosis. Maternal characteristics, obstetrics data, and T2DM incidence were compared by fetal sex using univariate and survival analyses, adjusted for confounders.
A total of 1637 individuals with GDM were included, with 808 carrying male fetuses and 829 carrying female fetuses. No significant differences were found in body mass index (BMI), glucose levels, or T2DM incidence between the two groups (6.2% for male vs. 7.1% for female fetuses, p = 0.48). Multivariate analysis identified maternal age and BMI as significant factors influencing the likelihood of developing T2DM.
The risk of developing T2DM after GDM does not vary based on fetal sex.
妊娠期糖尿病（GDM）会增加产后患2型糖尿病（T2DM）的风险，新出现的证据表明胎儿性别可能会影响妊娠结局。一些研究表明，怀有男胎的个体在孕期胰岛素敏感性降低且血糖水平较高。然而，胎儿性别是否会影响产后T2DM的长期风险仍不清楚。本研究旨在调查胎儿性别对GDM患者产后长达5年患T2DM风险的影响。
这项回顾性分析纳入了被诊断为GDM的孕妇，其随访数据来自Meuhedet健康维护组织的计算机化妊娠登记处和以色列国家糖尿病登记处。纳入标准包括通过异常口服葡萄糖耐量试验（oGTT）或葡萄糖耐量试验（GCT）诊断为GDM的单胎妊娠。排除标准为多胎妊娠或既往糖尿病诊断。使用单变量和生存分析按胎儿性别比较母体特征、产科数据和T2DM发病率，并对混杂因素进行调整。
总共纳入了1637例GDM患者，其中808例怀有男胎，829例怀有女胎。两组之间在体重指数（BMI）、血糖水平或T2DM发病率方面未发现显著差异（男胎为6.2%，女胎为7.1%，p = 0.48）。多变量分析确定母体年龄和BMI是影响患T2DM可能性的重要因素。
GDM后患T2DM的风险不因胎儿性别而异。
