Hs-CRP and TNF-α effects on postnatal umbilical coiling: impact assessment of the gestational diabetes mellitus in a prospective cohort study

Abstract

BackgroundHence, no study has been conducted to demonstrate specifically the relationship between gestational diabetes mellitus (GDM) status, inflammatory factors, and postnatal umbilical coiling index (pUCI), as understanding this relation could help to select the best appropriate interventions to save the fetus.MethodTo assess the impact of high sensitivity C-reactive protein (hs-CRP) and Tumor necrosis factor-Alpha (TNF-α) (in maternal venous and umbilical cord (UC) blood) on pUCI, comparing GDM and non-GDM groups.This prospective observational study contained 40 parturients in each of GDM and non-GDM groups, matched for maternal age, ethnicity, and parity. GDM diagnosis was confirmed by 24–28 weeks of gestation (WOG) and two-step strategy. The covariates of interest were maternal hs-CRP and TNF-α, measured at 37-41th WOG, and their UC analogous, measured during delivery. The gross morphologies were assessed immediately after delivery. The UC coiling was quantitatively assessed by the postnatal umbilical coiling index (pUCI)..ResultsNo significant difference of hs-CRP and TNF-α, in maternal venous blood or UC blood, was found between GDM/non-GDM groups. The mean (SD) of pUCI in GDM and non-GDM groups were 0.28 (0.15) and 0.24 (0.21) (p-value = 0.441), respectively. In GDM group, none of the four covariates of interest had significant effects on pUCI. Among the non-GDM patients, merely the UC hs-CRP had a direct association with pUCI, a Pearson correlation of r = 0.54 (p-value < .01).ConclusionsIn GDM group, no apparent relationship was observed between inflammatory factors and pUCI, although a direct association was detected between UC hs-CRP and pUCI in the non-GDM.Tweetable abstractThe umbilical cord high sensitivity C-reactive protein is directly correlated with postnatal umbilical coiling.