Impact of fetal sex on neonatal outcomes in women with gestational diabetes mellitus: a systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND: Research on the relationship between fetal sex and neonatal outcomes in pregnant women with gestational diabetes mellitus (GDM) is limited, and existing findings have yielded inconsistent results. Therefore, the aim of our study was to investigate the impact of fetal sex on neonatal outcomes in mothers with GDM. METHODS: We conducted a systematic search of six database) PubMed, Cochrane Library, Scopus, Web of Science, SID (Persian database), and Embase (up to January 1, 2025. The quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. Subgroup analyses differentiated between retrospective and prospective cohorts for the primary outcomes. Sensitivity analyses were performed using the leave-one-out approach to evaluate the robustness of the pooled results. Additionally, a meta-regression analysis was conducted, considering maternal age, gestational weight gain, and BMI for both male and female infants. RESULTS: From 702 studies screened, twelve observational studies were included in the analysis. The results revealed a significant increase in the rates of macrosomia (RR 1.47, 95% CI 1.23 to 1.77, 6 studies, 121,230 neonates; p < 0.0001), cesarean delivery (RR 1.05, 95% CI 1.03 to 1.06, 6 studies, 127,704 neonates; p < 0.0001), large for gestational age (LGA) (RR 1.21, 95% CI 1.08 to 1.36, 6 studies, 16,863 neonates; p < 0.0001), small for gestational age (SGA) (RR 1.14, 95% CI 1.05-1.25, 6 studies, 16,863 neonates; p = 0.002), and a 5-minute Apgar score of less than 7 (RR 1.26, 95% CI 1.11 to 1.43, 2 studies, 104,881 neonates; p = 0.0003) in male neonates compared to female neonates. However, there were no significant differences in the rates of preterm delivery (p = 0.86), jaundice (p = 0.75), and a 1-minute Apgar score of less than 7 (p = 0.08) between male and female neonates in women with GDM. CONCLUSION: The findings suggest that male infants are at a greater risk of experiencing specific adverse outcomes in the context of GDM. Further research is needed to establish tailored interventions and guidelines to improve the care and management of women with GDM and their infants.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.034 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.019 | 0.038 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".