Neonatal Hypoglycemia Related to Glycine Levels in Uncontrolled Gestational Diabetes Mellitus during Mid-Late Pregnancy: Multicenter, Prospective Case-Cohort Observational Study

Yuhang Long,Hanxi Zhang,Jianying Wang,Meijun Liu,Dan Xie,Jianyong Cao,Le Chen,Fangfang Jiang,Ting Hong,Wei Liu,Yaochao Yang,Zhaojuan Su,Yao Chen,Wujuan Chen,Xin Bao,Riccardo Calafiore

doi:10.1155/2020/9502870

Abstract

Aims. To explore the relationship between gestational diabetes mellitus (GDM) and neonatal cord blood amino acid and carnitine levels after GDM was diagnosed among pregnant women monitoring glycosylated haemoglobin levels of 5.5%-6.4% during mid-late gestation. Methods. In all, 7289 qualified participants were recruited and divided into two groups (GDM and control groups) between 1 July 2015 and 1 July 2020, and all maternal-neonatal data were collected and analyzed at three centers. Results. Interestingly, glycine in cord blood was not only significantly different between groups (15.52 vs. 6.67, P < 0.001 ) but also associated with neonatal hypoglycemia ( r = 0.132 , P < 0.001 ). Although glycine was an independent positive factor with neonatal hypoglycemia, it had lacked effective size to predict the risk of neonatal hypoglycemia ( b = 0.002 , P < 0.001 ). Conclusion. The study identifies some differences and relationships in maternal-neonatal data when the GDM group has fluctuating glycosylated haemoglobin levels of 5.5%-6.4% without hypoglycemic drug intervention, compared with the control group. Although umbilical cord blood of glycine levels has a lack of effective power to predict the risk of neonatal hypoglycemia, it is probably an independent factor involved in the maternal-neonatal glucolipid metabolism.

Highlights

Maternal disorder of glucose metabolism probably affected maternal-neonatal health and metabolism during pregnancy [1, 2]
On the basis of the International Association of Diabetes and Pregnancy Study Groups (IADPSG), over 17% of pregnant women would be diagnosed with gestational diabetes mellitus [3]
gestational diabetes mellitus (GDM) could be a common disturbance of carbohydrate metabolism in pregnant women and caused adverse pregnancy outcomes, such as maternal preeclampsia and neonatal hypoglycemia according to the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study [4]

Summary

Introduction

Maternal disorder of glucose metabolism probably affected maternal-neonatal health and metabolism during pregnancy [1, 2]. On the basis of the International Association of Diabetes and Pregnancy Study Groups (IADPSG), over 17% of pregnant women would be diagnosed with gestational diabetes mellitus [3]. GDM could be a common disturbance of carbohydrate metabolism in pregnant women and caused adverse pregnancy outcomes, such as maternal preeclampsia and neonatal hypoglycemia according to the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study [4]. All pregnant women in GDM would accept the dietary therapy and physical exercise treatment after the strict diagnosis standard of OGTT according to IADPSG. Glycosylated haemoglobin (HbA1c) levels were widely used for diabetic control. Some pregnant women were poor with the glucose regulation control based on the IADPSG recommendation range of HbA1c levels below 5.5% during mid-

Methods

Results

Discussion

Conclusion