Overexpression of circACTR2 in Gestational Diabetes Mellitus Predicts Intrauterine Death, Fetal Malformation, and Intrauterine Infection

Can Zhu,1 Yuning Liu,2 Haiying Wu1 1Department of Obstetrics and Gynecology, Henan Provincial People’s Hospital, Zhengzhou City, Henan Province, 450003, People’s Republic of China; 2Department of Neonatal Intensive Care Unit, Henan Provincial People’s Hospital, Zhengzhou City, Henan Province, 450003, People’s Republic of ChinaCorrespondence: Haiying WuDepartment of Obstetrics and Gynecology, Henan Provincial People’s Hospital, No. 7 Weiwu Road, Jinshui District, Zhengzhou City, Henan Province, 450003, People’s Republic of ChinaEmail haiyingwuhenan@163.comBackground: CircRNA actin-related protein 2 homolog (circACTR2) has been reported to participate in high glucose-induced disorders, while its role in gestational diabetes mellitus (GDM) is unknown. This study analyzed the expression pattern of circACTR2 in GDM and evaluated its predictive value for GDM and its adverse events.Methods: CircACTR2 expression in plasma of 200 pregnant females with a gestational age of about 1 month was analyzed once per month using RT-qPCR. The development of GDM was monitored until delivery. Adverse events, including premature delivery, miscarriage, intrauterine distress, intrauterine death, fetal malformation, intrauterine infection, hypertension, and macrosomia, were recorded.Results: During the follow-up, a total of 70 patients were diagnosed with GDM. The 70 GDM patients showed significantly higher plasma circACTR2 levels compared to the remaining 130 pregnant females. With the median plasma circACTR2 level in the first month as the cutoff value, the 200 patients were divided into the high and low circACTR2 level groups, and their GDM-free curves were plotted and compared. Patients in high circACTR2 level group showed a higher incidence of GDM. Moreover, among the 70 patients diagnosed with GDM, high circACTR2 levels were also closely correlated with higher rates of premature delivery, miscarriage, intrauterine death, fetal malformation, intrauterine infection, and hyper