Fırat ERSAN, Verda ALPAY, Kübra KURT BİLİRER, Barış BOZA, Hakan ERENEL
Journal of Medicine and Palliative Care - 2026;7(2):225-231
Aims: To assess the effects of maternal diabetes mellitus on fetal organ development through ultrasonographic assessment of pancreatic circumference, liver length, and subcutaneous fat thickness in gestational diabetes mellitus (GDM), pregestational diabetes mellitus (PreGDM), and normal pregnancies. A secondary objective is to evaluate the fetal pancreas-to-liver ratio as a novel marker of the relative effects of maternal diabetes on different organs. Methods: This prospective comparative study included 126 pregnant women divided into three groups: GDM (n=42), PreGDM (n=42), and control (n=42). Ultrasonographic measurements of fetal pancreatic circumference, liver length, and subcutaneous fat thickness were obtained between 28 and 36 weeks of gestation. Maternal demographic characteristics and birth parameters were collected from all participants. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance for detecting GDM. Results: Significant differences were observed in all fetal organ measurements between diabetic and control groups. Fetal pancreatic circumference was increased in both GDM (90.8+/-19.2 mm) and PreGDM (90.4+/-17.0 mm) compared to controls (81.0+/-9.8 mm, p=0.007). Fetal liver length showed a significant increase in GDM (53.4+/-12.2 mm) and PreGDM (51.2+/-9.6 mm) versus controls (44.5+/-5.6 mm, p<0.001). Fetal fat thickness demonstrated the most dramatic differences: GDM (5.3+/-1.1 mm) and PDM (4.8+/-1.1 mm) versus controls (3.7+/-0.7 mm, p<0.001). ROC analysis revealed high diagnostic performance for fat thickness (sensitivity=85%, specificity=79%). Conclusion: Maternal diabetes mellitus significantly affects fetal organ development, with consistent enlargement across multiple organ systems. Fetal subcutaneous fat thickness measurement shows high diagnostic potential for GDM screening, offering a valuable adjunct to traditional screening methods.
