Research
Obstetrics
Fetal male gender and the benefits of treatment of mild gestational diabetes mellitus

Presented as a poster at the 58th Annual Scientific Meeting of the Society for Gynecologic Investigation, Miami Beach, FL, March 16-19, 2011.
https://doi.org/10.1016/j.ajog.2012.03.015Get rights and content

Objective

We evaluated whether improvements in pregnancy outcomes after treatment of mild gestational diabetes mellitus differed in magnitude on the basis of fetal gender.

Study Design

This is a secondary analysis of a masked randomized controlled trial of treatment for mild gestational diabetes mellitus. The results included preeclampsia or gestational hypertension, birthweight, neonatal fat mass, and composite adverse outcomes for both neonate (preterm birth, small for gestational age, or neonatal intensive care unit admission) and mother (labor induction, cesarean delivery, preeclampsia, or gestational hypertension). After stratification according to fetal gender, the interaction of gender with treatment status was estimated for these outcomes.

Results

Of the 469 pregnancies with male fetuses, 244 pregnancies were assigned randomly to treatment, and 225 pregnancies were assigned randomly to routine care. Of the 463 pregnancies with female fetuses, 233 pregnancies were assigned randomly to treatment, and 230 pregnancies were assigned randomly to routine care. The interaction of gender with treatment status was significant for fat mass (P = .04) and birthweight percentile (P = .02). Among women who were assigned to the treatment group, male offspring were significantly more likely to have both a lower birthweight percentile (50.7 ± 29.2 vs 62.5 ± 30.2 percentile; P < .0001) and less neonatal fat mass (487 ± 229.6 g vs 416.6 ± 172.8 g; P = .0005,) whereas these differences were not significant among female offspring. There was no interaction between fetal gender and treatment group with regard to other outcomes.

Conclusion

The magnitude of the reduction of a newborn's birthweight percentile and neonatal fat mass that were related to the treatment of mild gestational diabetes mellitus appears greater for male neonates.

Section snippets

Materials and Methods

This is a secondary analysis of data that were collected during a randomized trial of treatment for mild GDM at 10 participating centers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network between October 2002 and November 2007.2 Institutional research board approval was obtained from each of the participating centers for the conduct of the primary study.

The details of study design, outcomes, and statistical analyses were

Results

There were 469 women with male fetuses and 463 women with female fetuses in the study population who met inclusion criteria for this analysis and for whom delivery data were available. As noted in the primary analysis,2 there was no significant difference in maternal body mass index on entry into the study. There were no significant interactions between fetal gender and treatment group with regard to most perinatal (Table 1) or maternal (Table 2) outcomes. There were, however, significant

Comment

The results of this secondary analysis from the National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network suggest that there may be an interaction between fetal gender and treatment of mild GDM such that there is a significantly greater reduction that is associated with treatment in both birthweight and accumulated fat mass in male fetuses than in female fetuses. There was, however, no interaction with regard to lean body mass.

The cause of this apparent

Acknowledgments

We thank the Subcommittee members who participated in protocol development and coordination between clinical research centers (Jo-Ann Tillinghast, RN, MSN, and Francee Johnson, RN, BSN), protocol/data management and statistical analysis (Elizabeth Thom, PhD), and protocol development and oversight (Catherine Y. Spong, MD).

The following list provides the names of the other members of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units

References (14)

There are more references available in the full text version of this article.

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Supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) grant numbers HD27915, HD34116, HD40485, HD34208, HD27869, HD40500, HD40560, HD34136, HD40544, HD27860, HD40545, HD53097, HD21410, HD27917, HD40512, HD53118, and HD36801; General Clinical Research Centers grant number M01-RR00034; and National Center for Research Resources grant numbers UL1-RR024989, M01-RR00080, UL1-RR025764, and C06-RR11234.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official views of the NICHD or National Institutes of Health.

The authors report no conflict of interest.

Cite this article as: Bahado-Singh RO, Mele L, Landon MB, et al. Fetal male gender and the benefits of treatment of mild gestational diabetes mellitus. Am J Obstet Gynecol 2012;206:422.e1-5.

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