{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:55:14Z","timestamp":1791561314603,"version":"4.3.4"},"reference-count":18,"publisher":"Walter de Gruyter GmbH","issue":"8","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2026-0377_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Gestational diabetes mellitus (GDM) is associated with fetal hyperinsulinemia, excessive adiposity, and adverse perinatal outcomes; sonographic markers of fetal adiposity, liver enlargement, and septal thickening may allow direct assessment of fetal metabolic adaptation. This study aimed to develop an ultrasound-based fetal metabolic score (FMS) estimating the risk of fetal hyperinsulinemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2026-0377_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The FMS was developed from a prospective cohort of 223 pregnant women (128 with GDM, 95 controls). Sonographic markers of neonatal hyperinsulinemia were identified using umbilical cord C-peptide above the 75th percentile as the reference outcome: thigh soft tissue thickness, abdominal subcutaneous fat thickness, fetal liver length, and interventricular septal thickness. Odds ratios from logistic regression were converted into weighted integer coefficients, and continuous measurements were categorized by gestational age-adjusted percentiles into a composite\u00a0score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2026-0377_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fetuses of GDM mothers showed significantly greater abdominal adiposity, liver length, and interventricular septal thickness than controls. Thigh soft tissue thickness (OR 1.62; 95\u202f% CI 1.25\u20132.09; p&lt;0.001), abdominal subcutaneous fat thickness (OR 1.57; 95\u202f% CI 1.23\u20131.99; p&lt;0.001), fetal liver length (OR 1.06; 95\u202f% CI 1.02\u20131.11; p=0.004), and interventricular septal thickness (OR 1.35; 95\u202f% CI 1.01\u20131.82; p=0.040) independently predicted elevated cord blood C-peptide. The FMS ranged from 0 to 44 points, integrating weighted contributions from adiposity, visceral growth, and cardiac remodeling markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2026-0377_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The FMS is a novel ultrasound-based approach for estimating fetal hyperinsulinemia risk. By integrating multiple manifestations of the fetal metabolic response to maternal hyperglycemia, it may assess fetal metabolic health more comprehensively than conventional biometry\u00a0alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2026-0377","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:56:43Z","timestamp":1787839003000},"page":"1336-1343","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-based prediction of fetal hyperinsulinemia: development of a fetal metabolic score"],"prefix":"10.1515","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0318-7635","authenticated-orcid":false,"given":"Roberto Noya","family":"Galluzzo","sequence":"first","affiliation":[{"name":"Division of Tocogynecology , University Hospital Polydoro Ernani of S\u00e3o Thiago, Federal University of Santa Catarina (UFSC) , Florian\u00f3polis , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3366-2767","authenticated-orcid":false,"given":"Karine Souza","family":"Da Correggio","sequence":"additional","affiliation":[{"name":"Division of Tocogynecology , University Hospital Polydoro Ernani of S\u00e3o Thiago, Federal University of Santa Catarina (UFSC) , Florian\u00f3polis , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4532-1417","authenticated-orcid":false,"given":"Aldo","family":"von Wangenheim","sequence":"additional","affiliation":[{"name":"Brazilian Institute for Digital Convergence, Federal University of Santa Catarina (UFSC) , Florian\u00f3polis , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8620-7293","authenticated-orcid":false,"given":"Heron","family":"Werner","sequence":"additional","affiliation":[{"name":"Department of Fetal Medicine , Biodesign Laboratory DASA\/PUC , Rio de Janeiro , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6145-2532","authenticated-orcid":false,"given":"Edward","family":"Araujo J\u00fanior","sequence":"additional","affiliation":[{"name":"Department of Obstetrics , Paulista School of Medicine\u00a0\u2013\u00a0Federal University of S\u00e3o Paulo (EPM-UNIFESP) , S\u00e3o Paulo , Brazil"},{"name":"Discipline of Woman Health , Municipal University of S\u00e3o Caetano do Sul (USCS) , S\u00e3o Caetano do Sul , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6694-6569","authenticated-orcid":false,"given":"Gustavo Yano","family":"Callado","sequence":"additional","affiliation":[{"name":"Albert Einstein Israelite College of Health Sciences (FICSAE), Albert Einstein Israelite Hospital , S\u00e3o Paulo , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1883-6087","authenticated-orcid":false,"given":"Alexandre Sherlley Casimiro","family":"Onofre","sequence":"additional","affiliation":[{"name":"Department of Clinical Analyses , Federal University of Santa Catarina (UFSC) , Florian\u00f3polis , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"2026100915172389168_j_jpm-2026-0377_ref_001","doi-asserted-by":"crossref","unstructured":"Barker, DJ. 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