Evaluation of the relationship between placental stiffness measured by shear wave elastography and perinatal outcomes in women with gestational diabetes mellitus

Abstract

Background Recently, studies on placental elastography in high-risk pregnancies continue to increase. The shear wave technique can contribute to the management of gestational diabetes mellitus (GDM) and improve perinatal outcomes by measuring placental stiffness. Purpose: To evaluate the relationship between placental stiffness measured by shear wave elastography (SWE) and perinatal outcomes in women with GDM. Material and Methods: This prospective cross-sectional study was conducted at our hospital between March and October 2020. The participants were divided into three groups: GDM-A1 group (regulated by dietary modifications); GDM-A2 group (needed pharmacologic treatment); and low-risk pregnancy (LRP) group. Both SWE and shear wave velocity (SWV) were measured in the placenta during pregnancy. Results In total, 111 women were included in the study. The mean SWE (kPa) values for the GDM-A1, GDM-A2, and LRP groups were 10.4 (range 3.1–23.3), 13 (range 4.3–29.6), and 8.3 (range 3.2–15.1), respectively. The mean HbA1c and fasting glucose values of diabetes groups showed strongly positive correlation with mean SWE and SWV values ( P < 0.001, r=0.875; P < 0.001, r=0.856; P < 0.001, r=0.791; P < 0.001, r=0.740), respectively. The SWE values of central maternal and fetal surfaces of the placenta ( P=0.01, r=0.242; P < 0.001, r=0.333) showed a moderately positive correlation with admission to the neonatal intensive care unit. Conclusion Placental stiffness has increased in the GDM-A2 group when compared to the GDM-A1 and LRP groups. We also observed a strong positive correlation between HbA1c, fasting glucose values, and increased elasticity values in diabetic patients with metabolic dysregulation that may have clinical value.