Background
No study has been conducted to specifically demonstrate the relationship between
gestational diabetes mellitus (GDM) status, inflammatory factors, and postnatal
umbilical coiling index (pUCI). Understanding this relationship could help select the
best interventions to save the fetus. To evaluate the effects of maternal venous and
umbilical cord blood levels of high sensitivity C-reactive protein (hs-CRP) and tumor
necrosis factor-alpha (TNF-alpha) on pUCI in GDM and non-GDM groups.
Methods
This prospective observational study included 40 participants in each of the GDM and
non-GDM groups, matched for maternal age, ethnicity, and parity. The GDM diagnosis was
confirmed by 24 to 28 weeks of gestation (WOG) and a 2-step strategy. The covariates of
interest were maternal hs-CRP and TNF-α, measured at 37 to 40 WOG, and their UC
analogous was measured during delivery. The gross morphologies were assessed immediately
after delivery. The UC coiling was quantitatively assessed by the pUCI. To compare the
GDM and non-GDM groups, the t test and the Mann-Whitney test were used for normal and
non-normal variables, respectively.
Results
There was not a significant difference in hs-CRP and TNF-a levels in maternal venous
blood or UC blood between the GDM and non-GDM groups. The mean (SD) of pUCI in the GDM
and non-GDM groups were 0.28 (0.15) and 0.24 (0.21) (
P
= 0.441),
respectively. In the GDM group, none of the 4 covariates of interest had significant
effects on the UCI. Among the non-GDM participants, merely the UC hs-CRP had a direct
association with the pUCI, with a Pearson correlation of 0.54 (
P
=
0.001). Impacts of hs-CRP and TNF-α on the pUCI were assessed using Poisson regression
models and no significant findings were detected (95% CI, 0.999-1.001, for all
parameters).
Conclusion
In the GDM group, no apparent association was observed between inflammatory factors
and pUCI, although a direct association was detected between UC hs-CRP and pUCI in the
non-GDM.