Fetal insulin production and complications in babies of diabetic mothers

Abstract

SummaryFetal pancreatic β-cell activity was studied by measuring amniotic fluid C-peptide and insulin concentrations by radio-immunoassay in 27 pregnancies. There were 9 non-diabetics, 9 well controlled diabetics and 9 poorly controlled diabetics.There was a correlation between C-peptide and insulin concentrations in the 27 patients. There was also a correlation between C-peptide and insulin concentration and maternal blood glucose levels.The study demonstrated a clear association between fetal hyperinsulinaemia and neonatal hypoglycaemia. Similarly, fetal macrosomia was significantly related to amniotic C-peptide and insulin levels.The relationship between insulin production and surfactant maturation in the fetus and the subsequent development of neonatal respiratory distress was less straightforward. It is thought that fetal insulin production in infants of diabetic mothers may not be primarily responsible for observed differences in surfactant maturation.