Does a first-degree family history of diabetes impact placental maternal and fetal vascular circulation and inflammatory response?

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Does a first-degree family history of diabetes impact placental maternal and fetal vascular circulation and inflammatory response?

J Clin Endocrinol Metab. 2017 Jun 23;:

Authors: Shargorodsky M, Kovo M, Schraiber L, Bar J

Abstract
Context: Heritability of diabetes is associated with hyperinsulinemia, impaired endothelial function, and inflammatory up-regulation. However, no studies have examined whether a family history of diabetes effects placental vascular circulation.
Objective: The present study was designed to investigate the impact of a first-degree family history of type 2 diabetes (FHD) on placental vascular circulation and inflammatory lesions.
Design: Observational cohort study.
Setting: Pregnant women who gave birth at Edith Wolfson Medical Center.
Patients: 339 pregnant women were divided into two groups according to presence of FHD: Group 1 included 225 subjects without FHD, and group 2 included 114 subjects with FHD.
Intervention: Placental histopathological examination.
Main Outcome Measures: Placental vascular supply abnormalities of maternal and fetal origin.
Results: Maternal vascular supply (MVS) abnormalities of the placenta were significantly higher in subjects with FHD, compared to subjects without FHD (p<0.005). Fetal vascular supply (FVS) abnormalities, as well as maternal and fetal inflammatory response did not differ significantly between groups. In the GLM analysis, FHD was an independent and significant predictor of MVS abnormalities and more than doubled the risk of this outcome. Gestational diabetes incidence was significantly higher in subjects with FHD (p<0.0001). Significant by-group differences in gestational diabetes persisted even after adjustment for age and BMI. Although incidence of gestational hypertensive disorders was significantly higher in individuals with FHD, after adjustment FHD did not significantly predict this outcome.
Conclusions: A first-degree FHD is significantly and independently associated with an increased rate of maternal vascular perfusion abnormalities and risk of gestational diabetes.

PMID: 28651343 [PubMed - as supplied by publisher]

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