The Relationship of Fetal Adrenal Gland Size with Fetal Liver Length and Fetal Abdominal Wall Fat Thickness in Mothers with and Without Gestational Diabetes - Abstract
Background: Given the possible association between maternal diabetes status and metabolic disorders in the fetus, such as hepatic dysfunction or subcutaneous fat mass, it is expected that there is a close relationship between fetal adrenal gland volume and these two indicators. Aim: We decided to examine the relationship of fetal adrenal gland size with fetal liver length and fetal abdominal wall fat thickness in mothers with gestational diabetes and also to compare it with non-diabetic mothers. Methods: This cross-sectional study was performed on 40 pregnant women in the third trimester of pregnancy suffering gestational diabetes under insulin therapy as the cases and 40 age and gestational age-matched pregnant women without diabetes as the controls. An ultrasound was performed for all participants in the third trimester of pregnancy to assess adrenal gland size, liver dimensions and fetal abdominal wall fat thickness. Results: The fetuses in diabetic group was found to have adrenal glands with significantly higher mean width, but with lower height leading similarity in mean adrenal volume as compared to non-diabetic group. The mean fetal abdominal wall fat thickness was significantly higher in diabetic than in non-diabetic groups. In diabetic groups, we found a direct association between height of adrenal gland and fetal abdominal wall fat thickness (p = 0.001). The length of adrenal gland was also positively associated with abdominal wall fat thickness (p = 0.001). However in non-diabetic group, we found no association between adrenal height and fetal abdominal wall fat thickness. Measuring liver length in the two groups showed significantly higher mean value in diabetic than in non-diabetic groups. No association was revealed between adrenal volume and liver length in diabetic group. In non-diabetic group, there was a significant direct association between adrenal volume and liver length (p = 0.008). Conclusion: Gestational diabetes is directly associated with increasing fetal abdominal wall fat thickness and liver length in fetus. The dimensions of adrenal gland in fetus are also associated with fetus abdominal wall fat thickness and liver length probably independent to maternal diabetic status.