New research in the Journal of Clinical Endocrinology & Metabolism supports previous findings that fetal sex may be associated with an increased risk of gestational diabetes mellitus (GDM) or subsequent type 2 diabetes diagnosis after pregnancy.

This retrospective cohort study reviewed population-based administrative databases in Ontario, Canada of all women with a singleton live-birth first pregnancy between April 2000 and March 2010 (n=642,987). Fetal sex, development of GDM in the first or second pregnancy, and development of type 2 diabetes before a second pregnancy were analyzed in the data.

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Carrying a male was associated with a greater risk of GDM in both the first pregnancy (odds ratio [OR] =1.03; 95% CI 1.0002–1.054) and second pregnancy (OR =1.04, 95% CI 1.01–1.08). Among women with a non-GDM first pregnancy while carrying a female, carrying a male in their second pregnancy was linked to an increased risk of GDM (OR = 1.07, 95% CI 1.01–1.14). Women who developed GDM in their first pregnancy and carried a female were more likely to be diagnosed with type 2 diabetes before a second pregnancy (OR = 1.07; 95% CI 1.01–1.12). This suggests that even without the added impact of a developing male fetus, some women may have had more serious underlying metabolic abnormalities that increased their risk of gestational diabetes.

One of the study authors, Baiju R. Shah, MD, PhD, of the University of Toronto, Sunnybrook Health Sciences Centre and the Institute for Clinical Evaluative Sciences in Toronto, Ontario, Canada, added that this study suggests that a male fetus leads to greater pregnancy-associated metabolic changes than a female fetus. The findings could benefit women in risk assessment for future disease, both in pregnancy and afterwards.

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