OBJECTIVE Gestational diabetes mellitus (GDM) increases the risk of fetal overgrowth as measured by two-dimensional ultrasonography. Whether fetal three-dimensional (3D) soft tissue and organ volumes provide additional insight into fetal overgrowth is unknown. RESEARCH DESIGN AND METHODS We prospectively evaluated longitudinal 3D fetal body composition and organ volumes in a diverse US singleton pregnancy cohort (2015–2019). Women were diagnosed with GDM, impaired glucose tolerance (IGT), or normal glucose tolerance (NGT). Up to five 3D ultrasound scans measured fetal body composition and organ volumes; trajectories were modeled using linear mixed models. Overall and weekly mean differences in fetal 3D trajectories were tested across glycemic status, adjusted for covariates. RESULTS In this sample (n = 2,427), 5.2% of women had GDM, and 3.0% had IGT. Fetuses of women who developed GDM compared with NGT had larger fractional arm and fractional fat arm volumes from 26 to 35 weeks, smaller fractional lean arm volume from 17 to 22 weeks, and larger abdominal area from 24 to 40 weeks. Fetuses of women with IGT had similar growth patterns, which manifested later in gestation and with larger magnitudes, and had larger fractional lean arm volume. No overall differences were observed among thigh or organ volumes across glycemic status. CONCLUSIONS Body composition differed in fetuses of GDM-complicated pregnancies, including larger arm and abdominal measures across the second and third trimesters. Patterns were similar in IGT-complicated pregnancies except that they occurred later in gestation and with larger magnitudes. Future research should explore how lifestyle and medication may alter fetal fat accumulation trajectories among hyperglycemic pregnancies.

中文翻译：

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基于三维超声的母体血糖状况和纵向胎儿身体成分和器官体积


目的 通过二维超声检查测量妊娠糖尿病 （GDM） 会增加胎儿过度生长的风险。胎儿三维 （3D） 软组织和器官体积是否能为胎儿过度生长提供额外的信息尚不清楚。研究设计和方法 我们前瞻性地评估了不同的美国单胎妊娠队列 （2015-2019） 中的纵向 3D 胎儿身体组成和器官体积。女性被诊断为 GDM 、糖耐量受损 （IGT） 或葡萄糖耐量正常 （NGT）。多达五次 3D 超声扫描测量了胎儿的身体成分和器官体积;轨迹使用线性混合模型进行建模。测试了胎儿 3D 轨迹的总体和每周平均差异，并针对协变量进行了调整。结果在该样本 （n = 2,427） 中，5.2% 的女性患有 GDM，3.0% 的女性患有 IGT。与 NGT 相比，发生 GDM 的女性的胎儿在 26 至 35 周时手臂部分体积和脂肪臂体积较大，17 至 22 周时瘦手臂体积较小，24 至 40 周时腹部面积较大。患有 IGT 的女性胎儿具有相似的生长模式，在妊娠后期表现出来，幅度更大，并且具有更大的瘦臂体积。在不同血糖状态下，大腿或器官体积之间未观察到总体差异。结论 GDM 复杂妊娠胎儿的体成分存在差异，包括妊娠中期和晚期手臂和腹部测量值较大。IGT 复杂妊娠的模式相似，只是它们发生在妊娠后期且幅度较大。未来的研究应探讨生活方式和药物如何改变高血糖妊娠中胎儿脂肪积累的轨迹。