Fetal Sex, Glucose and Lipid Metabolism, and Perinatal Outcomes in Gestational Diabetes Mellitus: A Retrospective Cohort Study

Aims There were some studies reported inconsistent results on the associations between fetal sex and maternal metabolism. This study aimed to examine the effect of fetal sex on maternal glucose and lipid metabolism and perinatal outcomes in women with gestational diabetes mellitus (GDM) during pregnancy in Chinese population. Methods This was a retrospective cohort study including 134 women diagnosed as GDM. All of them accepted 100g oral glucose tolerance test(OGTT) during 26–29 gestational week because of positive 50g glucose challenge test(GCT) and then had a regular follow-up. The clinical and laboratory data as well as perinatal outcomes were collected from Electronic Medical Record. Results Of 134 pregnant women with GDM, 64(47.76%) delivered a girl and 70(52.24%) delivered a boy. Homeostasis model assessment of β-cell function (HOMA-β) in women carrying a male fetus was significantly lower than in those carrying a female fetus [176(129.09,245.56) vs. 212(150.00,307.5), p  = 0.029]. There was no difference between two groups in maternal lipid metabolism. Large-for-gestational-age(LGA) fetus was more likely to happen on male fetus (14.8% vs. 3.1%, p  = 0.033), but there were no difference between two groups of the other perinatal outcomes. Higher maternal fasting blood glucose(OR 5.256, 95% CI 1.318,14.469) and lower HDL-C/LDL-C in women carrying male fetus suggested higher risk of LGA. Conclusions Women carrying a male fetus suggested decreased maternal β-cell function and increased percentage of LGA. The different management strategy of women with GDM between male and female fetus during pregnancy is necessary.