Maternal Diabetes and Infant Sex Ratio

Purpose of Review Evolutionary hypotheses on the ratio of males to females at birth posit that women terminate pregnancies with low likelihood of surviving and producing grandchildren. Thus, females are preferred to males under unfavorable conditions. Much of this literature has focused on catastrophic disruptions that induce maternal stress and result in fewer males. Diabetes may similarly affect the sex ratio. Recent Findings A male bias at birth among infants born to women with GDM is widely recognized; mild hyperglycemia experienced early in pregnancy may signal favorable conditions and warrant investment in males. There are sparse data on women with pregestational diabetes, but some evidence for a female bias born to those with type 1 diabetes and severe hyperglycemia (i.e., requiring insulin). Disease-related maternal stress in these women may lead to the selective termination of male fetuses. Further examination of pregestational diabetes stands to contribute to scientific understanding of the sex ratio.

Automated summary

Research suggests that infants born to women with gestational diabetes are more likely to be male, while women with pregestational diabetes may have a preference for female offspring. Disease-related maternal stress in diabetic women could result in the selective termination of male fetuses, indicating a potential impact on the sex ratio. Further study of pregestational diabetes is crucial for a deeper understanding of the sex ratio phenomenon.