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March 14, 2026BMC MedicineOpen Access

The role of male foetal sex on maternal and neonatal outcomes in pregnancies complicated by gestational diabetes—secondary analysis of a randomised placebo controlled clinical trial of metformin in gestational diabetes (EMERGE)

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Authors

CNChristine NewmanAAA. Alvarez-IglesiasKEKeelan Eyers

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Overview

Secondary analysis finds foetal sex affects outcomes in gestational diabetes, suggesting tailored interventions.

Key Points

  • This analysis aims to assess how male foetal sex influences maternal and neonatal outcomes in gestational diabetes and the effects of metformin.
  • Conducted a secondary analysis of the EMERGE randomised controlled trial.
  • Analyzed outcomes based on foetal sex and metformin exposure.
  • Evaluated insulin usage, fasting glucose levels at 32 and 38 weeks, and foetal size.
  • Higher plasma glucose levels at 60 minutes in women carrying male foetuses (9.69 vs. 9.37 mmol/L, p = 0.039).
  • Male pregnancies showed lower fasting glucose levels with metformin at 32 weeks (4.88 vs. 5.01 mmol/L, p = 0.014) and 38 weeks (4.49 vs. 4.69 mmol/L, p = 0.002).
  • Reduced insulin usage in male pregnancies exposed to metformin (38% vs. 53%, p = 0.014).
  • Female metformin-exposed offspring had higher rates of low birth weight (<2500 g) compared to placebo (8.3% vs. 1.9%, p = 0.032), an observation not seen in males.

Cite This Study

Newman et al. (2026) studied this question.

synapsesocial.com/papers/69b4fc6ab39f7826a300d3c8https://doi.org/10.1186/s12916-026-04778-z
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