The following is a summary of “Utility of In Vivo Magnetic Resonance Imaging Is Predictive of Gestational Diabetes Mellitus During Early Pregnancy,” published in the February 2023 issue of Endocrinology & Metabolism by Lee, et al.

Gestational diabetes (GDM) is a severe condition that can cause long-term negative health outcomes for both the mother and fetus. However, the role of magnetic resonance imaging (MRI) during early pregnancy in detecting GDM has not been extensively studied.

For a study, researchers sought to determine whether quantitative MRI measurements of placental volume and perfusion, in conjunction with maternal adiposity distribution, could aid in detecting GDM during early pregnancy. The study followed approximately 200 pregnant women from their first trimester until delivery. Two placental MRI scans were conducted at 14-16 weeks and 19-24 weeks gestational age, and placental volume and blood flow were calculated from placental regions of interest. In addition, the distribution of maternal adiposity was assessed using the subcutaneous fat area ratio (SFAR) and visceral fat area ratio (VFAR).

The study showed 21 out of 186 subjects (11.3%) developed GDM. VFAR was significantly higher in the GDM group than in the control group at both time points (P < 0.001 each). Placental volume was also greater in the GDM group compared to the control group at 19-24 weeks GA (P = 0.01). Combining VFAR, placental volume, and perfusion improved the predictive power of the model, with an AUC of 0.83 at 14-16 weeks (positive predictive value [PPV] = 0.77, negative predictive value [NPV] = 0.83) and 0.81 at 19-24 weeks GA (PPV = 0.73, NPV = 0.86).

In conclusion, the study demonstrated that a combination of MRI-based placental volume, perfusion, and visceral adiposity measurements during early pregnancy could detect significant changes in GDM and provide a proof of concept for predicting the subsequent development of GDM. The findings may have important implications for the early detection and management of GDM, which could improve maternal and fetal outcomes.

Reference: academic.oup.com/jcem/article/108/2/281/6762303