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• Clinical Article •
Association between gestational diabetes mellitus and brain development in very preterm infants: A quantitative 3D-ASL study
DING Tan  FU Yiwei  LI Sike  WANG Ning  LIU Xueyan  FENG Zhanqi  ZHOU Tian  LU Lin  ZHAO Xin 

DOI:10.12015/issn.1674-8034.2026.01.001.


[Abstract] Objective To use three-dimensional arterial spin labeling (3D-ASL) imaging technology to measure cerebral blood flow (CBF) in very premature infants born to mothers with gestational diabetes mellitus (GDM) and to analyze its correlation with metabolic and inflammatory markers in these infants.Materials and Methods One hundred very premature infants were recruited from the Third Affiliated Hospital of Zhengzhou University between April 2024 and March 2025. The infants were divided into a GDM group consisting of 50 cases and a control group including 50 cases. Both groups performed 3D T1 BRAVO, 3D-ASL, and normal MRI sequence scans. General clinical data and CBF values across several brain regions were gathered and analyzed across the two groups. The correlation between CBF values in markedly distinct brain areas and the initial blood glucose levels and inflammatory markers was examined.Results In comparison to the control group, the very premature infants in the GDM group had significantly higher birth weight, CBF values in multiple brain regions (left frontal lobe, right temporal lobe, bilateral occipital lobes, and bilateral basal ganglia), along with increased inflammatory markers (P < 0.05). The initial blood glucose levels in the GDM group were markedly lower than those in the control group (P < 0.05). The CBF values in the brain regions exhibiting differences between the two groups were positively correlated with procalcitonin levels (r = 0.665, 0.518, 0.627, 0.582, 0.495, 0.465, P < 0.05) and negatively correlated with initial blood glucose levels (r = -0.409, -0.448, -0.450, -0.447, -0.487, -0.501, P < 0.05).Conclusions 3D-ASL technology offers a noninvasive and dependable imaging modality for assessing brain development in very premature infants born to mothers with GDM. Alterations in blood flow parameters connect with clinical signs, providing significant references for the early detection and personalized management in these newborns, perhaps enhancing their prognosis.
[Keywords] gestational diabetes；very premature infants；arterial spin labeling imaging；magnetic resonance imaging；cerebral blood flow；blood glucose levels；inflammatory indicators

DING Tan1, 2, 3   FU Yiwei1, 2, 3   LI Sike1, 2, 3   WANG Ning1, 2, 3   LIU Xueyan1, 2, 3   FENG Zhanqi1, 2, 3   ZHOU Tian1, 2, 3   LU Lin1, 2, 3   ZHAO Xin1, 2, 3*  

1 Department of Medical Imaging, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

2 Henan International Joint Laboratory of Neuroimaging, Zhengzhou 450052, China

3 Henan Provincial Key Laboratory of Pediatric Neuroimaging Medicine, Zhengzhou 450052, China

Corresponding author: ZHAO X, E-mail: zdsfyzx@zzu.edu.cn

Conflicts of interest   None.

Received  2025-07-01
Accepted  2025-12-05
DOI: 10.12015/issn.1674-8034.2026.01.001
DOI:10.12015/issn.1674-8034.2026.01.001.

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