GDM sub-study of Fetal Growth Studies

Eunice Kennedy Shriver National Institute Of Child Health & Human Development

Investigators

Abstract

This is a prospective study of longitudinal risk factors of gestational diabetes mellitus (GDM) and a nested case control study of a comprehensive panel of biomarkers including metabolomics profiles focusing on the etiology and prediction of GDM and its implications for fetal growth. Initial findings indicated potential important roles of insulin growth factor (IGF) pathway (Zhu et al. Diabetes 2016), iron metabolism (Rawal et al Diabetologia 2017), lipids (Bao et al. Journal of Diabetes 2017), saturated fatty acids (Zhu et al. American Journal of Clinical Nutrition 2018), thyroid function markers (Rawal et al. Journal of Clinical Endocrinology and Metabolism 2018) and telomere length (Lin et al. Epidemiology 2018) during as early as the first trimester in the development of GDM. For instance, it was discovered that thyroid function in pregnant women may be involved in the pathophysiology of GDM (Rawal et al. Journal of Clinical Endocrinology and Metabolism 2018). These findings, in conjunction with previous evidence of thyroid-related adverse pregnancy outcomes, support the potential benefits of thyroid screening among pregnant women. In addition, a significantly increased risk of GDM was observed in association with saturated fatty acid levels as early as the first trimester of pregnancy (Zhu et al. American Journal of Clinical Nutrition 2018), providing impetus for future investigations that target circulating saturated fatty acids in pregnant women to improve our understanding of their distinct nutritional, metabolic, and physiologic roles in cardiometabolic outcomes. Recently, new research also discovered that HbA1C levels potentially can help identify women at risk for GDM early in pregnancy, when lifestyle changes may be more effective in reducing their risk (Hinkle et al. Scientific Reports 2018). Furthermore, new research found that womens adipokine levels (Hinkle et al. International Journal of Obesity 2018) and vitamin D status (Francis et al. Nutrients 2018) in pregnancy appear to be involved in regulating fetal growth. While more work is needed, the data offer insight into how maternal body fat composition may influence different aspects of fetal growth.