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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 2

(422) Impact of fetal sex on adverse pregnancy and neonatal outcomes in individuals with pre-existing diabetes.

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective: Pre-existing diabetes mellitus (DM) – diabetes identified prior to pregnancy - is increasing in prevalence among pregnant individuals and is associated with adverse maternal and neonatal outcomes. Prior work suggests that fetal sex impacts underlying placental dysfunction leading to differential pregnancy risks.  The objective of this study is to assess the impact of fetal sex on placentally-mediated adverse pregnancy outcomes in individuals with DM.

Study Design: This was a retrospective cohort study of 503 pregnant individuals with pre-existing DM and known fetal sex receiving care at a major urban academic center between 1998-2016. The exposure of interest was fetal/infant sex. The primary outcome was a composite of preterm birth, hypertensive disorder of pregnancy (HDP), small for gestational age (SGA), and stillbirth, and the secondary outcome was NICU admission.  A composite of large for gestational age (LGA), hypoglycemia, hyperbilirubinemia, shoulder dystocia, and respiratory distress syndrome (RDS) was assessed.  Mixed effects logistic regression models were built to assess the relationship between fetal sex and the pregnancy/neonatal outcomes, accounting for multiple pregnancies and adjusting for 1st Trimester BMI, parity, and race/ethnicity.   

Results: Of the 503 pregnant individuals included, 258 pregnancies had a female fetus (51%) and 245 pregnancies had a male fetus (49%) – Table 1; no significant differences in sociodemographic or clinical characteristics were observed between groups. No significant differences in either composite outcome was identified, however there was a significantly higher likelihood of NICU admissions for males (adjusted odds ratio 1.83 [1.14, 2.94], p=0.012, Table 2).

Conclusion:

Although we did not identify differences in composite adverse pregnancy or neonatal outcomes in individuals with DM by offspring sex, the significantly higher rate of NICU admission suggests male neonatal vulnerability to the impact of maternal DM and warrants further investigation.