Umbilical Cord Glycosylated Hemoglobin in Infants of Diabetic Mothers: Relationships to Neonatal Hypoglycemia, Macrosomia, and Cord Serum C-Peptide

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 hours 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.

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

BMC Pediatrics ◽

10.1186/s12887-021-02547-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ahlam M. Saber ◽

Magdy A. Mohamed ◽

Abdelrahim A. Sadek ◽

Ramadan A. Mahmoud

Keyword(s):

Umbilical Cord ◽

Diabetes Control ◽

P Value ◽

Maternal Weight ◽

Neonatal Hypoglycemia ◽

C Peptide ◽

Infants Of Diabetic Mothers ◽

Serial Serum ◽

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.

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Relationship between Umbilical Cord C-peptide and Risk of Hypoglycemia in Infants of Diabetic Mothers

Bangladesh Journal of Child Health ◽

10.3329/bjch.v36i2.13082 ◽

2012 ◽

Vol 36 (2) ◽

pp. 71-75

Author(s):

Mst Nurun Nahar Begum ◽

M Quamrul Hassan ◽

Kishwar Azad

Keyword(s):

Blood Glucose ◽

Child Health ◽

Umbilical Cord ◽

Clinical Characteristics ◽

C Peptide ◽

Infants Of Diabetic Mothers ◽

Significant Difference ◽

Peptide Level ◽

The Relationship ◽

Diabetic Mothers

Objective: To examine the relationship between umbilical cord C-peptide and risk of hypoglycemia in infants of diabetic mothers. Method: Sixty neonates born to diabetic mothers were studied in BIRDEM hospital. Thirty infants who developed hypoglycemia at any time during the first 24 hours of age were considered as cases. Another 30 infants who did not develop hypoglycemia during the first 24 hours were considered as controls. Umbilical cord C-peptide levels were measured in both groups. All babies were screened for hypoglycemia at 4, 6, 8, 12, 18 and 24 hours of life. Blood glucose value of less than 2.6 mmol/l was considered as hypoglycemia. Results: Clinical characteristics of cases and controls and their mothers did not show any significant difference. In 73.3% of cases hypoglycemia was detected by 6 hours of age. Most babies were asymptomatic (93.3%). It was found that IDMs who developed hypoglycemia had significantly higher cord C-peptide level at birth compared to those who remained normoglycemic (4.57±2.50 vs. 2.81± 2.11 ng/ml, P= 0.005). That means, there is significant association between raised level of cord C-peptide and hypoglycemia in IDMs. Conclusion: Hypoglycemia in infants of diabetic mothers associated with raised cord blood C-peptide levels. DOI: http://dx.doi.org/10.3329/bjch.v36i2.13082 Bangladesh J Child Health 2012; Vol 36 (2): 71-75

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1168 CORD PLASMA C-PEPTIDE/GLUCOSE [C-P/G] IN INFANTS OF DIABETIC MOTHERS [IDM]: RETROSPECTIVE AND PROSPECTIVE INDEX OF B-CELL FUNCTION

Pediatric Research ◽

10.1203/00006450-198104001-01194 ◽

1981 ◽

Vol 15 ◽

pp. 637-637

Author(s):

Edward S Ogata ◽

Boyd E Metzger ◽

Norbert Freinkel ◽

C Hunt

Keyword(s):

B Cell ◽

Cell Function ◽

C Peptide ◽

Infants Of Diabetic Mothers ◽

B Cell Function ◽

Cord Plasma ◽

Diabetic Mothers

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Influence of Maternal Glycemic Status (HbA1c) at Delivery and Risk of Hypoglycemia in Infants of Diabetic Mothers

BIRDEM Medical Journal ◽

10.3329/birdem.v2i2.12308 ◽

2012 ◽

Vol 2 (2) ◽

pp. 84-88

Author(s):

Mst Nurun Nahar Begum ◽

M Quamrul Hassan ◽

Maherun Nessa ◽

Kishwar Azad

Keyword(s):

Blood Glucose ◽

Hba1c Level ◽

Glycosylated Hemoglobin ◽

Good Control ◽

Significant Negative Correlation ◽

Glycemic Status ◽

Infants Of Diabetic Mothers ◽

Significant Difference ◽

Control Study ◽

Diabetic Mothers

Objective: To examine the influence of maternal HbA1c level at delivery and risk of hypoglycemia in infants of diabetic mothers. Method: This case-control study was done with sixty neonates born to diabetic mothers in BIRDEM hospital. Out of sixty neonates, 30 neonates who developed hypoglycemia during the first 24 hours of age were considered as cases and another 30 neonates who did not develop hypoglycemia during the first 24 hours were considered as controls. Maternal glycemic status was examined by measurement of Glycosylated hemoglobin (HbA1c) and level of <6 % considered good control. Babies were screened for hypoglycemia at birth, then 4, 6, 8, 12, 18 and 24 hours of life. Blood glucose value of less than 2.6 mmol/l was considered as hypoglycemia. Results: Clinical characteristics of newborns and their mothers of cases and controls did not show any significant difference. In majority of cases (73.3%) hypoglycemia was detected by 6 hours of age. Most of babies were asymptomatic (93.3%). Majority of mothers (76.7%) in controls and 46.7% of were in good glycemic controls (HbA1c <6%). The mean HbA1c level of mothers of cases was significantly higher than that of control mothers (6.02 ± 0.98 vs 5.44 ± 0.78; P = 0.014) and significant negative correlation between maternal HbA1c and blood glucose level of neonates ( r=0.422 p= 0.001). Conclusion: There is an association between maternal HbA1c level and neonatal hypoglycemia in infants of diabetic mothers.DOI: http://dx.doi.org/10.3329/birdem.v2i2.12308 (Birdem Med J 2012; 2(2): 84-88)

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895 FREE C-PEPTIDE LEVELS IN INFANTS OF DIABETIC MOTHERS: RELATIONSHIP TO HYPOGLYCEMIA, MACROSOMIA, AND HYALINE MEMBRANE DISEASE

Pediatric Research ◽

10.1203/00006450-197804001-00900 ◽

1978 ◽

Vol 12 ◽

pp. 513-513 ◽

Cited By ~ 1

Author(s):

I Sosenko ◽

J Kitzmiller ◽

S Loo ◽

K Gabbay ◽

P Blix ◽

...

Keyword(s):

Hyaline Membrane Disease ◽

C Peptide ◽

Infants Of Diabetic Mothers ◽

Hyaline Membrane ◽

Diabetic Mothers

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Prolonged Symptomatic Neonatal Hypoglycemia Associated with Maternal Chlorpropamide Therapy

PEDIATRICS ◽

10.1542/peds.42.5.824 ◽

1968 ◽

Vol 42 (5) ◽

pp. 824-825

Author(s):

Preston Zucker ◽

Gilbert Simon

Keyword(s):

Case Report ◽

Cesarean Section ◽

Blood Sugar ◽

White Male ◽

Neonatal Hypoglycemia ◽

Infants Of Diabetic Mothers ◽

Repeat Cesarean Section ◽

Diabetic Mothers

Ordinarily, the hypoglycemia of infants of diabetic mothers is brief and asymptomatic.1 It is considered to result from fetal hyperinsulinism secondary to prenatal hyperglycemia. The infant described below had prolonged symptomatic hypoglycemia associated with maternal chlorpropamide (Diabinese) therapy. Case Report The patient, a 3,715 gm white male, was the product of a 37-week gestation of a gravida 3, para 2, A positive, 36-year-old mother by repeat cesarean section. The mother, a mild diabetic since age 31, had been receiving 250 mg chlorpropamide twice daily, including the morning of her delivery. The infant's blood sugar was 20 mg/100 ml at 4 hours of age, and he was then transferred to Babies Hospital for further care.

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