Key result
Maternal diabetes was associated with significantly larger fetal subcutaneous fat areas, detectable by an AI classifier with a 70% detection rate and 82% positive predictive value.
Why the study?
Strategies to estimate fetal body composition beyond fetal growth to better predict metabolic complications later in life are needed, even when maternal diabetes is well-controlled.
Does well-controlled maternal diabetes increase fetal subcutaneous fat mass in fetuses without growth alterations?
Observational
Does well-controlled maternal diabetes increase fetal subcutaneous fat mass in fetuses without growth alterations?
Maternal diabetes increases fetal subcutaneous fat mass even in fetuses with normal growth, which can be effectively detected using AI-enhanced 3D-ultrasound analysis.
May reflect increased fetal adiposity in well-controlled diabetes; leaves open prospective validation of AI ultrasound detection.
Pregnant women with diabetes often present impaired fetal growth, which is less common if maternal diabetes is well-controlled. However, developing strategies to estimate fetal body composition beyond fetal growth that could better predict metabolic complications later in life is essential. This study aimed to evaluate subcutaneous fat tissue (femur and humerus) in fetuses with normal growth among pregnant women with well-controlled diabetes using a reproducible 3D-ultrasound tool and offline TUI (Tomographic Ultrasound Imaging) analysis. Additionally, three artificial intelligence classifier models were trained and validated to assess the clinical utility of the fetal subcutaneous fat measurement. A significantly larger subcutaneous fat area was found in three-femur and two-humerus selected segments of fetuses from women with diabetes compared to the healthy pregnant control group. The full classifier model that includes subcutaneous fat measure, gestational age, fetal weight, fetal abdominal circumference, maternal body mass index, and fetal weight percentile as variables, showed the best performance, with a detection rate of 70%, considering a false positive rate of 10%, and a positive predictive value of 82%. These findings provide valuable insights into the impact of maternal diabetes on fetal subcutaneous fat tissue as a variable independent of fetal growth.
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Borboa-Olivares et al. (2023) conducted an observational in Maternal diabetes. Maternal diabetes vs. Healthy pregnant control group was evaluated on Subcutaneous fat area in femur and humerus segments. Maternal diabetes was associated with significantly larger fetal subcutaneous fat areas, detectable by an AI classifier with a 70% detection rate and 82% positive predictive value.
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