The effect of diabetes during pregnancy on fetal renal parenchymal growth
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ORIGINAL ARTICLE
The effect of diabetes during pregnancy on fetal renal parenchymal growth Sonja Brennan1,2 · Yogavijayan Kandasamy2,3,4 · Donna M. Rudd2 · Michal E. Schneider5 · Rhondda E. Jones2 · David L. Watson2,6 Received: 16 May 2020 / Accepted: 21 July 2020 © Italian Society of Nephrology 2020
Abstract Aims/hypothesis Diabetes in pregnancy is thought to adversely affect the developing fetal kidneys. The rate of gestational diabetes is increasing globally with major consequences for future renal function. Very little is known about the impact of hyperglycaemia on the fetal renal parenchyma which contains the developing nephrons. The aim of this study was to measure the fetal renal parenchymal thickness and evaluate whether diabetes during pregnancy affects the growth of the fetal kidneys. Methods This prospective, observational study used serial ultrasound measurements to evaluate the fetal renal parenchymal growth of 55 pregnancies with diabetes compared to 72 control pregnancies. Mixed effects modelling was used to analyse the data. Results The renal parenchyma of fetuses from mothers with gestational diabetes was significantly thicker than those from the control group (LR Chisq = 4.8, df = 1, p = 0.029), however, the difference was proportional to the larger size of these fetuses. Fetuses of pregestational diabetics demonstrated no significant difference in renal parenchymal thickness compared to the control group even though they were also larger fetuses. Parenchymal growth slowed with increasing abdominal circumference in the pregestational diabetic group, suggesting an adverse effect on nephrogenesis, however this did not reach statistical significance. Conclusions/interpretation Our study provides unique data on how diabetes during pregnancy influences fetal kidney growth. Appropriate management of diabetic pregnancies may mitigate some of the adverse effects on the fetal kidneys. Increasing Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40620-020-00815-z) contains supplementary material, which is available to authorized users. * Sonja Brennan [email protected]; [email protected] 1
Ultrasound Department, Townsville University Hospital, IMB 47, P.O. Box 670, Douglas, Townsville, QLD 4810, Australia
2
Division of Tropical Health and Medicine, James Cook University, Townsville, Australia
3
Department of Neonatology, Townsville University Hospital, Townsville, Australia
4
Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, The University of Newcastle, Newcastle, Australia
5
Department of Medical Imaging and Radiation Sciences, Monash University, Melbourne, Australia
6
Maternal Fetal Medicine Unit and Department of Obstetrics and Gynaecology, Townsville University Hospital, Townsville, Australia
13
Vol.:(0123456789)
Journal of Nephrology
degrees of hyperglycaemia, as seen sometimes in pregestational diabetes, may affect nephrogenesis; however larger studi
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