{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T13:08:18Z","timestamp":1773925698798,"version":"3.50.1"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Health Sciences"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Aim<\/jats:title>\n                    <jats:p>To assess the sensitivity of the fetal aortic isthmus (AoI) Doppler changes in predicting the adverse perinatal outcome with pregestational and gestational diabetes mellitus compared with other Doppler parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      This prospective case\u2013control study was undertaken between Agust 2023 and May 2024 in Ankara Etlik City Hospital perinatology department. Maternal age, gravidity, parity, maternal body mass index (BMI), gestational age at ultrasonographic examination, fetal AoI, umbilical artery (UA), middle cerebral artery (MCA), and uterine artery (UtA) Doppler parameters were compared between four groups: Pregestational diabetes mellitus (PGDM) (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930), diet-regulated gestational diabetes mellitus (DRGDM) (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930), insulin-regulated GDM (IRGDM) (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930), and controls (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200975). HbA1c values were evaluated only in pregnancies complicated by diabetes mellitus. The composite adverse perinatal outcomes (CAPO) was defined as Apgar score at 5\u00a0min\u2009&lt;\u20097, cord blood pH\u2009&lt;\u20097, sepsis, phototherapy for neonates, respiratory distress syndrome (RDS), mechanical ventilation, neonatal intensive care unit (NICU) admission, hypoglycemia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Maternal age and BMI levels were significantly higher in the PGDM group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). HbA1c levels were significantly higher in the PGDM group compared to other diabetic groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). While most Doppler parameters were similar across groups, PGDM cases had higher rates of prematurity (40%), cesarean delivery (90%), NICU admission (60%), and CAPO (63.3%) compared to controls (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01 for all). HbA1c was positively correlated with MCA S\/D, AoI-PSV, and AoI S\/D (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). ROC analysis showed that AoI Ta-max and EDV had modest predictive value for CAPO (AUC\u2009=\u20090.627 and 0.638, respectively;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The AoI Doppler flow measurements may serve as a potential adjunctive marker in the assessment of adverse perinatal outcomes in pregnancies complicated by diabetes mellitus. However, further large-scale prospective studies are warranted to validate its clinical applicability and establish its role in routine obstetric practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-026-08378-3","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T09:29:40Z","timestamp":1773912580000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Aortic isthmus Doppler hemodynamics and \u0131mpacts on perinatal outcomes in pregestational and gestational diabetes mellitus"],"prefix":"10.1007","volume":"313","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3924-3723","authenticated-orcid":false,"given":"Zeynep","family":"Seyhanli","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2567-2850","authenticated-orcid":false,"given":"Gulsan","family":"Karabay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6137-0270","authenticated-orcid":false,"given":"Ahmet Arif","family":"Filiz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9983-2306","authenticated-orcid":false,"given":"Dilara","family":"Duygulu Bulan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6570-1006","authenticated-orcid":false,"given":"Recep Taha","family":"Agaoglu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6824-881X","authenticated-orcid":false,"given":"Gizem","family":"Aktemur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0202-4981","authenticated-orcid":false,"given":"Betul Tokgoz","family":"Cakir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3182-4312","authenticated-orcid":false,"given":"Kadriye Yakut","family":"Yucel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8719-1879","authenticated-orcid":false,"given":"Zehra Vural","family":"Yilmaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"issue":"9","key":"8378_CR1","doi-asserted-by":"publisher","first-page":"1668","DOI":"10.1007\/s00125-017-4314-3","volume":"60","author":"HR Murphy","year":"2017","unstructured":"Murphy HR, Bell R, Cartwright C et al (2017) Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study. 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The research was conducted in adherence to the guidelines outlined in the Declaration of Helsinki. The Ethics Committee of Ankara Etlik City\u00a0Hospital granted approval (Number: AE\u015eH-EK1-2023\u2013358).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"133"}}