Amniotic fluid insulin levels identify the fetus at risk of neonatal hypoglycaemia

Abstract

Identification of the hyperinsulinaemic fetus before delivery might allow the intensification of maternal insulin therapy leading to a reduction in incidence and severity of diabetic fetopathy. Pregnancy with a normoinsulinaemic fetus could be allowed to continue to the onset of spontaneous labour, which might result in a lower CS rate.

Gestational Diabetes: A Review of the Current Literature and Guidelines

“…Furthermore, there is evidence that neonatal hypoglycemia is much more related to macrosomia per se than to maternal GDM (54). The most important question is: do these metabolic problems really have any permanent negative consequences for the babies' long-term health?…”

Urinary excretion of inositol phosphoglycan P‐type in gestational diabetes mellitus

“…Release of P‐IPG in response to insulin has been reported in several cell lines [29] and in normal human term placenta [16]. Hyperinsulinaemia has been reported in fetuses of diabetic mothers [30] with subsequent increased insulin content in the amniotic fluid [31]. Amniotic fluid is enriched with P‐IPG, and the fetus is possibly the source of these molecules [17].…”

Management of Diabetes in Pregnancy: Comparison of Guidelines with Current Practice at Austrian and Australian Obstetric Center

“…Amniocentesis is considered a reliable intervention to detect fetal hyperinsulinism at the Austrian center (23). Furthermore, several studies have suggested that amniotic fluid insulin levels are a sensitive and representative fetal parameter and a direct measure of fetal metabolic control, independent of placental function (24,25). Amniocentesis in gestational diabetes pregnancies remains uncommon in other centers, as it poses a debatable invasive procedure.…”