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The Impact of Maternal Gestational Diabetes Mellitus on Minipuberty in Boys
Karolina Kowalcze1,2, Sofia Burgio3, Johannes Ott4
1Department of Pathophysiology, Faculty of Medicine, Academy of Silesia, Rolna 43, 40-555 Katowice, Poland.
Insights
Poorly controlled gestational diabetes mellitus (GDM) in mothers significantly impacts infant boys' reproductive axis activity and genital development during minipuberty. Adequate GDM control showed no adverse effects on male infant development.
Area of Science:
- Pediatric Endocrinology
- Reproductive Health
- Maternal-Fetal Medicine
Background:
- Minipuberty is crucial for infant sexual maturation.
- Maternal health conditions during pregnancy can influence the infant's reproductive axis.
- Gestational diabetes mellitus (GDM) is a significant maternal health concern.
Purpose of the Study:
- To investigate the effect of maternal gestational diabetes mellitus (GDM) on the progression of minipuberty in male infants.
- To determine if GDM control influences reproductive hormone levels and genital development in newborns.
- To assess the long-term impact of maternal GDM on the male reproductive axis during the first year of life.
Main Methods:
- A prospective, matched cohort study involving three groups of male infants: those born to mothers with poorly controlled GDM, adequately controlled GDM, and healthy pregnancies.
- Repeated measurement of salivary testosterone, androstenedione, DHEA-S, estradiol, and urinary FSH and LH levels over 12 months.
- Correlation of hormone levels with genital organ size (testicular volume, penile length) measured at each visit.
Main Results:
- Male infants of mothers with poorly controlled GDM exhibited elevated gonadotropins, higher testosterone, lower DHEA-S, and prolonged LH/testosterone detection periods.
- Hormone levels in these infants correlated with maternal glycated hemoglobin levels.
- Infants exposed to poorly controlled GDM showed increased testicular and penile size compared to controls.
- No significant differences were observed between infants of adequately controlled GDM mothers and controls.
Conclusions:
- Poorly controlled gestational diabetes mellitus adversely affects the male infant's reproductive axis activity.
- Maternal GDM, when poorly managed, can lead to enhanced postnatal growth of male genital organs.
- Adequate control of GDM during pregnancy mitigates negative impacts on male infant reproductive development.
Background/Objectives:
Minipuberty is thought to play an important role in the sexual maturation of infants. Maternal disorders during pregnancy were found to have an impact on the activity of the reproductive axis in the first year of life. This prospective, matched, cohort study was aimed at investigating whether the course of minipuberty in boys is affected by maternal gestational diabetes mellitus (GDM).
Methods:
The study population consisted of three matched groups of boys: infants born to women with poorly controlled GDM, sons of women with adequately controlled GDM, and infants of healthy women with normal carbohydrate tolerance during pregnancy (control group). Salivary levels of testosterone, androstenedione, DHEA-S and estradiol, and urinary concentrations of FSH and LH were repeatedly measured over the first 12 months of life. Hormone levels were correlated with the size of genital organs (testicular volume and penile length), which were measured at each visit.
Results:
Compared with the remaining groups, the male offspring of women with poorly controlled GDM were characterized by higher concentrations of both gonadotropins, higher salivary testosterone levels, lower salivary DHEA-S concentrations, and longer periods of detection for LH and testosterone. Levels of gonadotropin, testosterone and DHEA-S in sons of mothers with poorly controlled GDM correlated with mean levels of glycated hemoglobin during pregnancy. Moreover, the infant boys assigned to this group were characterized by larger sizes of the testes and penis. Over the entire study period, there were no differences in hormone levels, testicular volume and penile length between sons of adequately treated women with GDM and sons of healthy women.
Conclusions:
The obtained results indicate that GDM, if poorly controlled, may affect the activity of the reproductive axis and postnatal growth of male genital organs in the offspring.
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