Correlation Between Placental Calcification, Umbilical Artery Hemodynamic Parameters and Delivery Outcomes in Patients with Gestational Diabetes

Hongjing Chen,1 Qiang Gu,2 Linyu Qian,1 Fang Wang31Department of Obstetrics, Affiliated Maternity and Child Healthcare Hospital of Nantong University, Nantong City, Jiangsu Province, People’s Republic of China; 2Department of Breast Surgery, Affiliated Maternity and Child Healthcare Hospital of Nantong University, Nantong City, Jiangsu Province, People’s Republic of China; 3Department of Emergency, Affiliated Maternity and Child Healthcare Hospital of Nantong University, Nantong City, Jiangsu Province, People’s Republic of ChinaCorrespondence: Qiang Gu, Department of Breast Surgery, Affiliated Maternity and Child Healthcare Hospital of Nantong University, No. 399, Shiji Avenue, Nantong City, Jiangsu Province, People’s Republic of China, Email Guqiang828@126.comObjective: To investigate the correlation between the degree of placental calcification, umbilical artery hemodynamic parameters, and delivery outcomes in patients with gestational diabetes mellitus (GDM).Methods: A total of 190 GDM patients admitted to our hospital were retrospectively selected as the research subjects; gestational weeks ranged from 28 to 42. According to the placental calcification degree detected by ultrasound before delivery, they were divided into Grade 0 (n=62), Grade I (n=58), Grade II (n=45), and Grade III (n=25). Clinical data of all subjects were collected, and the umbilical artery hemodynamic parameters [systolic peak velocity/end-diastolic velocity (S/D), resistance index (RI), pulsatility index (PI)] and delivery outcome-related indicators were compared among groups. Spearman rank correlation analysis was used to explore the correlation between placental calcification degree and umbilical artery hemodynamic parameters. Multivariate Logistic regression analysis was used to screen independent risk factors for adverse delivery outcomes in patients with GDM.Results: There were significant differences in umbilical artery S/D, RI and PI among patients with different placental calcification degrees (F=108.75, 82.73, 158.20, all P< 0.001). Spearman rank correlation analysis showed that placental calcification degree was positively correlated with umbilical artery S/D, RI and PI in patients with GDM (r=0.760, 0.730, 0.817, all P< 0.001). There were statistically significant differences in cesarean section rate, preterm delivery rate, fetal distress rate and macrosomia rate among groups (χ2=42.984, 16.052, 47.556, 11.798, all P< 0.001). Multivariate Logistic regression analysis showed that Grade II placental calcification, Grade III placental calcification, and umbilical artery S/D ≥ 3.0 were independent risk factors for adverse delivery outcomes in patients with GDM.Conclusion: Placental calcification degree was closely correlated with umbilical artery hemodynamic parameters in patients with GDM. Grade II and Grade III placental calcification and umbilical artery S/D ≥ 3.0 could all affect the occurrence of adverse delivery outcomes in patients with GDM.Keywords: gestational diabetes mellitus, placental calcification, umbilical artery hemodynamics, delivery outcomes, correlation