Role of umbilical cord C-peptide levels in early prediction of hypoglycemia in infants of diabetic mothers

Abstract

Background Until now, diabetes during pregnancy has been associated with a high risk of maternal, fetal, and neonatal morbidities and mortalities. The main aim of this study was to evaluate the risk factors of hypoglycemia in infants of diabetic mothers (IDMs) and to study the relationship between umbilical cord (UC) C peptide levels and the risk of developing hypoglycemia. Material and methods UC blood C-peptide and serial serum blood glucose measurements were done for all included singleton newborns born to diabetic mothers during the study period. Maternal and neonatal data such as gestational age, maternal age, maternal weight, types of diabetics and its control, maternal glycated hemoglobin (HbA1C), birth weight, Apgar score, and neonatal complete blood picture were collected. Results In total, 83 IDMs met the inclusion criteria. Fifty-four (65.06%) developed hypoglycemia and 29 (34.94%) remained normoglycemic. However, there were no significant differences between hypoglycemic and normoglycemic IDMs in terms of types of maternal diabetics (P value = 0.41), its duration (P value = 0.43). The hypoglycemia peak occurred within the first 3 h of life, with 33.11 ± 8.84 mg/dl for the hypoglycemia group and 54.10 ± 6.66 mg/dl for the normoglycemic group (P value < 0.0001). Most of the babies had no hypoglycemic manifestation (96.30%). Neonates with hypoglycemia their mothers had poor diabetes control in the last trimester (HbA1C 7.09 ± 0.96%) compared to normoglycemic babies (HbA1C 6.11 ± 0.38%), (P-value < 0.0001). The mean (SD) of UC C-peptide level in hypoglycemic neonates increased to 1.73 ± 1.07 ng/ml compared to normoglycemic ones with 1.08 ± 0.81 ng/ml (P value = 0.005). Conclusion Poor diabetes control, especially in the last trimester, is associated with neonatal hypoglycemia. Increased UC C-peptide levels could be used as an early indicator for the risk of developing neonatal hypoglycemia and a predictor for babies need neonatal admission.

Measurement of C-Peptide Level in The Umbilical Cord of Infants of Diabetic Mothers and Its Relationship to The Risk of Hypoglycemia

“…Regarding the demographic data, three studies examined hypoglycemic versus normoglycemic groups in infants of diabetic mothers. They showed no significant differences in maternal age or weight between these groups, aligning with our findings demonstrated similar results in cases and controls (6)(7)(8). Our findings indicated that the hypoglycemic and normoglycemic groups showed no significant differences in gestational age at birth or 1-minute Apgar scores.…”

“…However, significant differences emerged regarding birth weight and 5minute Apgar scores between the two groups. Similarly, a comparable finding in gestational age and 1-minute Apgar scores between the hypoglycemic and normoglycemic groups but highlighted no significant distinctions in neonatal weight or 5-minute Apgar scores, was noted (6). Additionally, a study (8) reported no significant differences in newborn characteristics between case and control groups, while another (7) found no significant disparities in gestational age and Apgar scores at 1 and 5 minutes between hypoglycemic and normoglycemic groups.…”

Associations of cord blood meta-inflammation and vitamin D with neurodevelopmental delay: A prospective birth cohort study in China

“…The current analysis reported the significance of cord serum C-peptide levels above P90 (defined as fetal hyperinsulinemia) to increased risks of neurodevelopmental delay. Increasing evidence has indicated that cord blood C-peptide was associated with maternal insulin sensitivity, fetal hyperinsulinemia and/or neonatal hypoglycemia ( 21 , 22 ). There have been few studies to date on the impact of cord serum C-peptide on neurodevelopmental delay.…”

The relationship between neonatal hypoglycaemia and cord blood C‐peptide levels in neonates of birthing individuals with type 1 diabetes

“…A recent study, 15 including 83 neonates born to diabetic individuals (35 individuals had GDM, 45 individuals had type 2 diabetes, and 3 had T1D) showed that higher CBCP levels were significantly associated with neonatal hypoglycaemia. The association persisted after adjusting for birthing individual age, diabetes duration, mode of delivery, and birth weight.…”