Prenatal Ultrasonographic Markers of Macrossomia and C-Peptide in Gestational Diabetes Mellitus: A Prospective Cohort Study

Galluzzo, Roberto Noya; Da Correggio, Karine Souza; von Wangenheim, Aldo; Callado, Gustavo Yano; Werner, Heron; Araujo Júnior, Edward; Castro, Pedro Teixeira; Calagna, Glória; Onofre, Alexandre Sherlley Casimiro

doi:10.3390/diagnostics15161989

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Prenatal Ultrasonographic Markers of Macrossomia and C-Peptide in Gestational Diabetes Mellitus: A Prospective Cohort Study

by

Roberto Noya Galluzzo

¹,

Karine Souza Da Correggio

¹,

Aldo von Wangenheim

²

,

Gustavo Yano Callado

³

,

Heron Werner

⁴

,

Edward Araujo Júnior

^5,6

,

Pedro Teixeira Castro

⁴,

Glória Calagna

^7,*

and

Alexandre Sherlley Casimiro Onofre

⁸

¹

Division of Tocogynecology, University Hospital Polydoro Ernani of São Thiago, Federal University of Santa Catarina (UFSC), Florianópolis 88036-800, Brazil

²

Brazilian Institute for Digital Convergence, Federal University of Santa Catarina (UFSC), Florianópolis 88040-900, Brazil

³

Discipline of Woman Health, Albert Einstein Israelite College of Health Sciences (FICSAE), Albert Einstein Israelite Hospital, São Paulo 05653-000, Brazil

⁴

Department of Fetal Medicine, Biodesign Laboratory DASA/PUC, Rio de Janeiro 22451-900, Brazil

⁵

Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo 04023-062, Brazil

⁶

Discipline of Woman Health, Municipal University of São Caetano do Sul (USCS), São Caetano do Sul 09521-160, Brazil

⁷

Villa Sofia Cervello Hospital, University of Palermo, 90100 Palermo, Italy

⁸

Department of Clinical Analyses, Federal University of Santa Catarina (UFSC), Florianópolis 88036-800, Brazil

^*

Author to whom correspondence should be addressed.

Diagnostics 2025, 15(16), 1989; https://doi.org/10.3390/diagnostics15161989

Submission received: 20 June 2025 / Revised: 28 July 2025 / Accepted: 7 August 2025 / Published: 8 August 2025

(This article belongs to the Special Issue Diagnostic Techniques in Obstetrics and Gynecology: Current Practices and Future Directions)

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Abstract

Objective: To investigate the association between prenatal ultrasonographic markers of macrossomia and C-peptide, a neonatal hyperinsulinemia marker, in pregnancies complicated by gestational diabetes mellitus (GDM), with a focus on fetal adipose tissue thickness, liver length, and interventricular septal thickness. Methods: This prospective cohort study included 223 pregnant women followed from 28 to 36 weeks of gestation in two referral centers in Brazil. The GDM group and matched controls underwent serial ultrasound assessments of fetal biometry, including thigh, abdominal, and subscapular skinfolds, fetal liver length, and interventricular septum thickness. Neonatal hyperinsulinemia was assessed using umbilical cord C-peptide levels. Statistical analyses included t-tests, chi-square tests, correlation analyses, and multivariate logistic regression. Results: Fetuses of mothers with GDM exhibited significantly greater abdominal [t(221) = −3.999, p < 0.01] and subscapular [t(221) = −2.502, p = 0.02] skinfolds, liver length [t(221) = −3.785, p < 0.01], and interventricular septum [t(221) = −4.781, p < 0.01] thickness. However, umbilical cord C-peptide levels did not differ significantly between groups [t(189) = −1.724, p = 0.09]. Only weak correlations were found between fetal ultrasound markers and C-peptide levels. Among all parameters, subcutaneous tissue thickness showed the highest (ρ = 0.30), though still limited, predictive value. Conclusion: Fetuses of mothers with GDM demonstrated increased measures of liver length, subscapular adiposity, and interventricular septal thickness compared to controls. However, these prenatal biometric markers showed weak correlations with neonatal C-peptide levels.

Keywords: gestational diabetes mellitus; prenatal ultrasound; neonatal hyperinsulinemia; C-peptide

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MDPI and ACS Style

Galluzzo, R.N.; Da Correggio, K.S.; von Wangenheim, A.; Callado, G.Y.; Werner, H.; Araujo Júnior, E.; Castro, P.T.; Calagna, G.; Onofre, A.S.C. Prenatal Ultrasonographic Markers of Macrossomia and C-Peptide in Gestational Diabetes Mellitus: A Prospective Cohort Study. Diagnostics 2025, 15, 1989. https://doi.org/10.3390/diagnostics15161989

AMA Style

Galluzzo RN, Da Correggio KS, von Wangenheim A, Callado GY, Werner H, Araujo Júnior E, Castro PT, Calagna G, Onofre ASC. Prenatal Ultrasonographic Markers of Macrossomia and C-Peptide in Gestational Diabetes Mellitus: A Prospective Cohort Study. Diagnostics. 2025; 15(16):1989. https://doi.org/10.3390/diagnostics15161989

Chicago/Turabian Style

Galluzzo, Roberto Noya, Karine Souza Da Correggio, Aldo von Wangenheim, Gustavo Yano Callado, Heron Werner, Edward Araujo Júnior, Pedro Teixeira Castro, Glória Calagna, and Alexandre Sherlley Casimiro Onofre. 2025. "Prenatal Ultrasonographic Markers of Macrossomia and C-Peptide in Gestational Diabetes Mellitus: A Prospective Cohort Study" Diagnostics 15, no. 16: 1989. https://doi.org/10.3390/diagnostics15161989

APA Style

Galluzzo, R. N., Da Correggio, K. S., von Wangenheim, A., Callado, G. Y., Werner, H., Araujo Júnior, E., Castro, P. T., Calagna, G., & Onofre, A. S. C. (2025). Prenatal Ultrasonographic Markers of Macrossomia and C-Peptide in Gestational Diabetes Mellitus: A Prospective Cohort Study. Diagnostics, 15(16), 1989. https://doi.org/10.3390/diagnostics15161989

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Prenatal Ultrasonographic Markers of Macrossomia and C-Peptide in Gestational Diabetes Mellitus: A Prospective Cohort Study

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