The Influence of Maternal Diabetes on Placental Function and Fetal Brain Development: A Review of Advanced Imaging Methods

Objective: Diabetes mellitus (DM) is one of the most common medical complications of pregnancy and is associated with increased maternal and fetal morbidity and mortality. The placenta has a unique role as a transient organ that can profoundly influence the lifelong health of both mother and child. In pregnancies complicated by diabetes, the placenta plays a central role in bridging maternal vascular and metabolic effects on fetal neurodevelopment. The objective of this study is to review the current literature on in vivo placental and fetal neurodevelopment in pregnant women with DM. Study Design: We present a narrative literature review detailing human studies of placental and fetal neurodevelopment in pregnant persons with DM, along with promising new avenues of in vivo placental assessments. Results: Advances in imaging, particularly sonography and magnetic resonance imaging, provides novel insights on placental structure and function, as well as fetal brain development in pregnant women with DM. Conclusions: Improving our understanding of the in vivo consequences of maternal DM may provide new opportunities to intervene and mitigate adverse pregnancy outcomes in future.