The placenta has a central function in fetal glucose supply and placental volume has received rising awareness as a potential predicting factor for adverse pregnancy outcomes. We aimed to examine whether placental volume is a prognostic marker for metabolic perturbations affecting both mother and child. Data from 100 women participating in a longitudinal cohort study of healthy pregnant women were obtained. Placental volume was assessed via transabdominal ultrasound at gestational weeks 12-14. Additional ultrasound measurements were conducted at gestational weeks 23-25, 28-30, and 34-36 to assess fetal anthropometry. HbA1c was measured in first trimester blood samples. Both cross-sectional and prospective associations between first trimester placental volume and selected fetal and maternal parameters were examined using multivariable linear regression models. Interactions by gender were observed for associations with HbA1c, anterior abdominal wall thickness (AAWT), gestational weight gain and estimated fetal weight. A higher first trimester placental volume was related to higher HbA1c levels in the first trimester, higher AAWT measures in the third trimester, and greater gestational weight gain in women carrying a male fetus only (all p = 0.02). In women carrying a female fetus, a positive association was observed between placental volume and estimated fetal weight at gestational week 34-36 (p = 0.045). None of the other maternal or fetal parameters were related to placental volume (p ≥ 0.1). Our results indicate first trimester placental volume to be a potential prognostic factor for maternal glucose metabolism and both fetal and maternal anthropometric perturbations particularly for those mothers carrying a male fetus.
Keywords: GDM; fetal anthropometry; first trimester; maternal HbA1c; placental volume; pregnancy; sex-specific.
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