Observational studyActa diabetologica2022
The impact of fetal sex on risk factors for gestational diabetes and related adverse pregnancy outcomes.
Observational study in Acta diabetologica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Impact of fetal sex on neonatal outcomes in women with gestational diabetes mellitus: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2025Pooled it
- Maternal Gestational Diabetes Impairs Fetoplacental Insulin-Induced Vasodilation via AKT/eNOS Pathway and Reduces Placental Efficiency.International journal of molecular sciences · 2025Article
- AI-based analysis of fetal growth restriction in a prospective obstetric cohort quantifies compound risks for perinatal morbidity and mortality and identifies previously unrecognized high risk clinical scenarios.BMC pregnancy and childbirth · 2025Observational
- Article
- Association between foetal sex and adverse neonatal outcomes in women with gestational diabetes.Archives of gynecology and obstetrics · 2024Article
- The influence of fetal sex on antenatal maternal glucose and insulin dynamics.Frontiers in clinical diabetes and healthcare · 2024Review
- The Plasma Glucose Threshold Values Associated with Adverse Pregnancy Outcomes Among Asian Indian Pregnant Women: MAASTHI Birth Cohort Analysis.Diabetes, metabolic syndrome and obesity : targets and therapy · 2024Article
- Pregestational exposure to hormonal combined contraceptives and risk of gestational diabetes: an observational retrospective population study.Acta diabetologica · 2023Observational
- Maternal Gestational Diabetes Is Associated with High Risk of Childhood Overweight and Obesity: A Cross-Sectional Study in Pre-School Children Aged 2-5 Years.Medicina (Kaunas, Lithuania) · 2023Article
- Increased basal insulin sensitivity in late pregnancy in women carrying a male fetus: a cohort study.Biology of sex differences · 2022Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo investigate whether fetal sex affects the impact of classical GDM risk factors on the diagnosis of gestational diabetes (GDM) as well as on related adverse pregnancy outcomes.
methodsThis retrospective observational study concerned 206,917 singleton live births born to 170,126 women aged 15-45 over the years 2010-2018 in Tuscany, Italy. GDM was identified by administrative data-sources in 21,613 pregnancies (10.5%) by assessing, through multiple logistic models, whether fetal sex modified the risk of GDM driven by maternal risk factors, and whether it modified the risk of adverse outcomes such as prematurity (birth ≤ 37th gestational week), large for gestational age (LGA), unplanned caesarean sections, or 5-min-Apgar-index ≤ 7 in pregnancies with GDM.
resultsGDM was diagnosed in 21,613 pregnancies (10.5%). Male fetal sex predicted a higher adjusted risk of GDM: OR = 1.05(95% CI: 1.01-1.07); p < 0.0009. In pregnancies with female sex, pre-pregnancy obesity amplified the risk of GDM: OR = 1.09(95% CI: 1.01-1.19); p = 0.04. In pregnancies with GDM, carrying a female fetus increased the risk of LGA associated with pregestational obesity OR = 1.45(95% CI: 1.15-1.81); p = 0.001, and in primiparous pregnancies, it protected mothers from the risk of unplanned caesarean sections OR = 0.80(95%CI: 0.67-0.92); p = 0.001.
conclusionsWhile male fetal sex is associated with rise in the risk of GDM, giving birth to a girl amplifies the excess GDM risk driven by pregestational obesity, thus increasing the risk of LGA in pregnancies with GDM. Additionally, female fetal sex in pregnancies with GDM seems to protect from the risk of unplanned caesarean sections in primiparous pregnancies.
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