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Evaluating the Impact of Fetal Sex on Gestational Diabetes Mellitus Following Interaction with Maternal Characteristics

  • Reproductive Epidemiology: Original Article
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Abstract

Fetal-sex-specific changes to placental immunity and metabolism occur in response to obesity. Few studies have determined if fetal sex interacts with maternal characteristics to alter risk of gestational diabetes mellitus (GDM). Among 43,727 singleton pregnancies, we examined the association between male fetal sex and GDM using log-binomial logistic regression to calculate relative risks (RR) and 95% confidence intervals (CI). Interactions were examined between fetal sex and maternal characteristics on the risk of GDM by calculating relative excess risk due to interaction. After adjusting for body mass index, race/ethnicity, maternal age, education, and gravidity, male fetal sex was not associated with GDM (RRadj. 0.95, 95% CI 0.93, 1.04). We found a positive interaction between male fetal sex and obesity (p = 0.04). Nonobese women with male fetuses were less likely to develop GDM, but in the presence of obesity, an opposite trend was observed. There was a positive interaction between male fetal sex and GDM on the risk of preterm delivery < 37-weeks gestation (p = 0.0006). In response to underlying maternal obesity, fetal sex may modify the risk of GDM. In addition, male fetal sex may increase the occurrence of preterm birth among women with GDM.

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Data Availability

The data underlying this article were provided by PeriBank under license/by permission. Access to data requires permission from PeriBank [13].

Code Availability

All analyses were done using SAS software version 9.4, SAS Institute, Cary, North Carolina. Access to code is available upon request.

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Acknowledgements

We thank PeriBank for allowing us access to their data and thank the women who participated. In PeriBank, subject data were obtained following full and informed subject consent with the generous support from the Departments of Obstetrics and Gynecology and Pathology and Laboratory Medicine at Texas Children’s Hospital and Baylor College of Medicine on the PeriBank protocol (IRB H-26364, Dr. Kjersti Aagaard P. I.).

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Authors and Affiliations

  1. Department of Preventive Medicine and Population Health, University of Texas Medical Branch-Galveston, Galveston, TX, USA

    Sarah Kaitlyn Hooks & Brandie DePaoli Taylor

  2. Department of Internal Medicine, Piedmont Athens Regional Medical Center, Athens, GA, USA

    Olayinka Abiodun-Ojo

  3. Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA

    Akaninyene I. Noah, Ramkumar Menon & Brandie DePaoli Taylor

  4. Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    Ashley V. Hill

  5. Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA

    Maria J. Perez-Patron

Authors
  1. Sarah Kaitlyn Hooks
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  2. Olayinka Abiodun-Ojo
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  3. Akaninyene I. Noah
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  7. Brandie DePaoli Taylor
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Contributions

BT, AH, and MP were involved in the concept and design of the study. BT, SH, and AN carried out the data analysis. All authors assisted with data interpretation. SH wrote the manuscript with support from BT, AH, MP, OAO, and RM. All authors approved manuscript prior to submission.

Corresponding author

Correspondence to Brandie DePaoli Taylor.

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Ethics Approval

The University of Texas Medical Branch Institutional Review Board determined this secondary data analysis was not human subjects’ research.

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Trained study personnel obtained informed consent from all participants.

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All authors participated in the study and development of the manuscript titled “Evaluating the impact interaction of maternal characteristics and fetal sex on gestational diabetes mellitus.” All authors have read the final version and give consent for the article to be published in the Reproductive Sciences journal.

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The authors declare no competing interests.

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Hooks, S.K., Abiodun-Ojo, O., Noah, A.I. et al. Evaluating the Impact of Fetal Sex on Gestational Diabetes Mellitus Following Interaction with Maternal Characteristics. Reprod. Sci. 30, 1359–1365 (2023). https://doi.org/10.1007/s43032-022-01106-7

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  • DOI: https://doi.org/10.1007/s43032-022-01106-7

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