Maternal Glucose Levels Research Articles

The relationship between nutrition adequacy level, physical activity, and pregnancy outcomes in mothers and infants

Pregnancy outcomes are affected by many factors: nutrition and physical activity. This study aims to determine the relationship between physical activity and nutritional adequacy level of pregnant women in the third trimester with pregnancy outcomes, namely maternal fasting blood glucose levels, blood pressure and amniotic fluid volume, and baby's birth weight and length. An observational study on a cohort was conducted on 34 pregnant women in their third trimester and followed until delivery in the Ciampea sub-district, Bogor, Indonesia. The data were processed through descriptive analysis for each variable. Bivariate tests between the predictor and outcome variables were performed using Pearson's correlation and Multiple Regression at 95% CI. Based on multiple regression analysis, we found that the samples' fasting blood glucose in the third trimester was predicted to be 36,9% positively affected by pre-pregnancy body mass index (b= 2,521; p= 0,009) and total physical activity during the third trimester (b= 0,055; p= 0,006). In conclusion, the nutritional adequacy level of macronutrients in the third trimester has not yet significantly affected pregnancy outcomes in this study. It is suggested that pregnant women should avoid prolonged sedentary activity and increase appropriate exercise to achieve maternal health and improve birth outcomes.

"Residential greenness, gestational diabetes mellitus (GDM) and microbiome diversity during pregnancy".

Gestational diabetes mellitus (GDM) is associated with reduced gut microbiota richness that was also reported to differ significantly between those living in rural compared to urban environments. Therefore, our aim was to examine the associations between greenness and maternal blood glucose levels and GDM, with microbiome diversity as a possible mediator in these associations. Pregnant women were recruited between January 2016 and October 2017. Residential greenness was evaluated as mean Normalized Difference Vegetation Index (NDVI) within 100, 300 and 500m buffers surrounding each maternal residential address. Maternal glucose levels were measured at 24-28 weeks of gestation and GDM was diagnosed. We estimated the associations between greenness and glucose levels and GDM using generalized linear models, adjusting for socioeconomic status and season at last menstrual period. Using causal mediation analysis, the mediation effects of four different indices of microbiome alpha diversity in first trimester stool and saliva samples were assessed. Of 269 pregnant women, 27 participants (10.04%) were diagnosed with GDM. Although not statistically significant, adjusted exposure to medium tertile levels of mean NDVI at 300m buffer had lower odds of GDM (OR=0.45, 95% CI: 0.16, 1.26, p=0.13) and decreased change in mean glucose levels (β=-6.28, 95% CI: 14.91, 2.24, p=0.15) compared to the lowest tertile levels of mean NDVI. Mixed results were observed at 100 and 500m buffers, and when comparing highest tertile levels to lowest. No mediation effect of first trimester microbiome on the association between residential greenness and GDM was observed, and a small, possibly incidental, mediation effect on glucose levels was observed. Our study suggests possible associations between residential greenness and glucose intolerance and risk of GDM, though without sufficient evidence. Microbiome in the first trimester, while involved in GDM etiology, is not a mediator in these associations. Future studies in larger populations should further examine these associations.

Preoperative lignocaine nebulisation for attenuation of the pressor response of laryngoscopy and tracheal intubation in patients with severe preeclampsia undergoing caesarean section delivery: A randomised double-blind controlled trial.

Following induction of general anaesthesia, direct laryngoscopy and endotracheal intubation usually cause tachycardia and hypertension due to increased sympathetic activity. This response is generally exaggerated in hypertensive patients. This study aimed to evaluate the effectiveness of preoperative lignocaine nebulisation in attenuating the pressor response to laryngoscopy and endotracheal intubation in patients with severe preeclampsia undergoing caesarean delivery. After ethical approval, we conducted this randomised, double-blind study, which included 110 patients with severe preeclampsia who underwent caesarean delivery under general anaesthesia. These patients were randomly allocated into two groups to receive either preoperative nebulisation of lignocaine 2% in a dose of 4.5 mg/kg (not exceeding 400 mg) in the lignocaine group or nebulisation of an equivalent volume of 0.9% NaCl in the saline group. The primary objective was the systolic blood pressure after tracheal intubation. The secondary objectives included heart rate, maternal serum cortisol and blood glucose levels, grade of cough during emergence, postoperative sore throat and hoarseness of voice, neonatal Apgar score and umbilical blood gas. The systolic blood pressure was significantly lower in the lignocaine group compared to the saline group at 1, 3 and 5 min after endotracheal intubation and after delivery of the foetus (P = 0.001, 0.003, 0.002 and 0.019, respectively). Similarly, the heart rate was significantly lower in the lignocaine group versus saline group at 1 and 3 min after endotracheal intubation (P = 0.041 and 0.042, respectively). Preoperative lignocaine nebulisation in a dose of 4.5 mg/kg effectively attenuated the pressor response to laryngoscopy and endotracheal intubation in patients with severe preeclampsia undergoing caesarean delivery.

Maternal glucose levels and future risk of developing cardiovascular disease: a systematic review and meta-analysis protocol

IntroductionHyperglycaemia during pregnancy has been considered as one of the risk factors for cardiovascular diseases (CVDs) among women. Although the evidence regarding the association between gestational diabetes mellitus (GDM) and...

Neonatal infection in Sub-Saharan Africa: a cross-sectional pilot study on bacterial pathogens and maternal risk factors.

Although child morbidity and mortality could be reduced in Sub-Saharan Africa during the last years both remain high. Since neonatal infections play a major role, we conducted a cross-sectional pilot study in the lake region of Western Tanzania in order to analyze not only the prevalence of neonatal infection with its bacterial etiology including antimicrobial resistance pattern but also to detect potential maternal risk factors. We screened 156 women for potential risk factors and examined their neonates for clinical signs of an infection including microbiological verification. All women were interviewed for medical history and their socio-economic background. High-vaginal swabs (HVS) of pregnant women and blood cultures of sick infants were investigated for bacterial pathogens using culture followed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) or polymerase-chain-reaction (PCR)-based assays. Antimicrobial resistances were determined using a disk diffusion test and verified by VITEK 2. Maternal malaria, blood glucose, and hemoglobin levels were determined by rapid tests and helminth infections by stool microscopy. Our results showed a prevalence of 22% for neonatal infections. In total, 57% of them had culture-positive bloodstream infections with Gram-negative bacteria being the most prevalent. All these expressed resistance against ampicillin. The prevalence of maternal infection with helminths or Plasmodium was low, indicating that anti-worming strategies and intermittent preventive treatment of malaria for pregnant women (IPTp) are effective. The study identified maternal urinary tract infection (UTI) and an elevated blood glucose level as potential maternal risk factors for early neonatal infection, an elevated blood glucose level, and maternal anemia for a late-onset infection. Our study, therefore, indicates that monitoring maternal UTI in the last trimester as well as levels of maternal hemoglobin and blood glucose might be important to predict and eventually manage neonatal infections. As Gram-negative bacteria with resistance to ampicillin were most prevalent in culture-proven neonatal sepsis, WHO recommendations for calculated antibiosis in the sick young infant should be discussed.

Continuous monitoring of fetal gross movement and maternal glucose level using newly developed methods

There is no consensus on the relationship between maternal glucose levels and fetal movements. This study aimed to investigate the correlation between gross fetal movements and maternal glucose levels in the hours around food intake. This was an observational study with 2 newly developed technologies, which were a glucose monitoring system and a fetal movement acceleration measurement recorder. A total of 15 women with singleton pregnancies were provided with the glucose monitoring system that automatically recorded their glucose levels every 15 minutes. In addition, fetal movements were recorded using the fetal movement acceleration measurement recorder, for 4 hours starting from 1 hour before lunch, once a week beginning at 28 weeks of gestation. For the four 1-hour periods, the ratios of the number of 10-second epochs with fetal movement divided by the total number of epochs (defined as the fetal movement parameter) were compared at the earlier (28-33 weeks of gestation), later (34-39 weeks of gestation), and overall (28-39 weeks of gestation) gestational weeks using analysis of variance analyses. A linear regression analysis was developed between the glucose level and the movement parameter for the earlier, later, and overall gestational weeks. All data were divided into 4 categories: (1) both the glucose level and the fetal movement parameter increased from the previous 15 minutes; (2) the glucose level increased, but the fetal movement parameter did not increase; (3) the glucose level did not increase, but the fetal movement parameter increased; and (4) both glucose level and fetal movement parameter did not increase. The numbers for each category were compared for the earlier, later, and overall gestational weeks using χ2 analyses. There was no significant change in the fetal movement parameter among the four 1-hour periods at the earlier (P=.509), later (P=.884), and overall (P=.816) gestational weeks. There was a positive correlation between the glucose level and the movement parameter at 28 to 33 weeks of gestation (P=.001), but not at 33 to 39 (P=.129) and 28 to 39 (P=.115) weeks of gestation. Compared with fetuses whose mothers did not have increased glucose levels, fetuses whose mothers had increased glucose levels moved more at 28 to 33 weeks of gestation (P=.031), but not at 34 to 39 (P=.398) and 28 to 39 (P=.238) weeks of gestation. Having a meal did not change gross fetal movement counting; however, there are positive correlations between maternal glucose level and gross fetal movement at 28 to 33 weeks of gestation, but not at 34 to 39 weeks of gestation, for both glucose values and value changes under natural conditions of the mother and fetus.

IDF2022-0499 The association between maternal glucose levels in pregnancy and post-partum hypertension

IDF2022-0499 The association between maternal glucose levels in pregnancy and post-partum hypertension

Association of increased fetal epicardial fat thickness with maternal pregestational and gestational diabetes

Objective To evaluate the changes of fetal epicardial fat thickness (EFT) in pregnancies with pregestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM) and to identify the diagnostic effectiveness of fetal EFT in differentiating PGDM and GDM from normal pregnancies. Methods The study was conducted with pregnant women who admitted to perinatology department between October 2020 and August 2021. Patients were grouped as PGDM (n = 110), GDM (n = 110), and control (n = 110) for comparison of fetal EFT. EFT was measured in all three groups at 29 weeks of gestation. Demographic characteristics and ultrasonographic findings were recorded and compared. Results The mean fetal EFT was significantly higher in PGDM (1.47 ± 0.083 mm, p < .001) and GDM (1.40 ± 0.082 mm, p < .001) groups compared to control group (1.19 ± 0.049 mm) and was also significantly higher in PGDM group than GDM group (p < .001). Fetal EFT was significantly positively correlated with maternal age, fasting, 1st hour, 2nd hour glucose values, HbA1c, fetal abdominal circumference, and deepest vertical pocket of amniotic fluid (p < .001). Fetal EFT value of 1.3 mm diagnosed PGDM patients with a sensitivity of 97.3% and a specificity of 98.2%. Fetal EFT value of 1.27 mm diagnosed GDM patients with a sensitivity of 94% and a specificity of 95%. Conclusions Fetal EFT is greater in pregnancies with diabetes than in normal pregnancies, and also greater in PGDM than in GDM. In addition, fetal EFT is strongly correlated with maternal blood glucose levels in diabetic pregnancies.

ASSOCIATION BETWEEN MATERNAL BASAL GLUCOSE LEVEL AND INTRAUTERINE GROWTH RESTRICTION: A COMPARATIVE CROSS-SECTIONAL STUDY

Background: Intrauterine life is the most pivotal period of development that determines vital outcomes in postnatal life. Diabetes Mellitus may lead to disturbed fetal growth and maternal vasculopathy resulting in placental insufficiency with subsequent development of intrauterine growth restriction (IUGR). This study aims to find an association between hyperglycemia and the risk of IUGR, comparing pregnancies with IUGR with those with adequate for gestational age pregnancies.&#x0D; Methods: This cross sectional study was conducted in Federal Post Graduate Medical Institute (FPGMI) from January 2015 to January 2016, including 106 pregnant women using non-probability convenient sampling technique. Participants were divided into two groups: Group A comprises of pregnant women with adequate for gestational age pregnancies (n=53) and groups B includes pregnant women with intrauterine growth restricted pregnancies (n=53). Random blood sugar level was estimated by glucose/oxidase test and IUGR was confirmed by ultrasonography at 28-35 weeks of gestation. Shapiro-Wilk test was used to examine data normality and independent t-test was used to compare statistically significant difference. A p- value of &lt;0.05 was considered significant.&#x0D; Results: Mean basal sugar level of group A was 98.9 ± 7.1 mg/dL and that of group B was 97.9 ± 6.0mg/dL. This mean difference was not statistically significant (p-value= 0.566).&#x0D; Conclusion: We found no statistically significant association between raised maternal basal glucose level and the occurrence of intrauterine growth restriction at 28-35 weeks of pregnancy.

Metabolic perturbations in pregnant rats exposed to low-dose perfluorooctanesulfonic acid: An integrated multi-omics analysis

Emerging epidemiological evidence has linked per- and polyfluoroalkyl substances (PFAS) exposure could be linked to the disturbance of gestational glucolipid metabolism, but the toxicological mechanism is unclear, especially when the exposure is at a low level. This study examined the glucolipid metabolic changes in pregnant rats treated with relatively low dose perfluorooctanesulfonic acid (PFOS) through oral gavage during pregnancy [gestational day (GD): 1–18]. We explored the molecular mechanisms underlying the metabolic perturbation. Oral glucose tolerance test (OGTT) and biochemical tests were performed to assess the glucose homeostasis and serum lipid profiles in pregnant Sprague-Dawley (SD) rats randomly assigned to starch, 0.03 and 0.3 mg/kg·bw·d groups. Transcriptome sequencing combined with non-targeted metabolomic assays were further performed to identify differentially altered genes and metabolites in the liver of maternal rats, and to determine their correlation with the maternal metabolic phenotypes. Results of transcriptome showed that differentially expressed genes at 0.03 and 0.3 mg/kg·bw·d PFOS exposure were related to several metabolic pathways, such as peroxisome proliferator-activated receptors (PPARs) signaling, ovarian steroid synthesis, arachidonic acid metabolism, insulin resistance, cholesterol metabolism, unsaturated fatty acid synthesis, bile acid secretion. The untargeted metabolomics identified 164 and 158 differential metabolites in 0.03 and 0.3 mg/kg·bw·d exposure groups, respectively under negative ion mode of Electrospray Ionization (ESI-), which could be enriched in metabolic pathways such as α-linolenic acid metabolism, glycolysis/gluconeogenesis, glycerolipid metabolism, glucagon signaling pathway, glycine, serine and threonine metabolism. Co-enrichment analysis indicated that PFOS exposure may disturb the metabolism pathways of glycerolipid, glycolysis/gluconeogenesis, linoleic acid, steroid biosynthesis, glycine, serine and threonine. The key involved genes included down-regulated Ppp1r3c and Abcd2, and up-regulated Ogdhland Ppp1r3g, and the key metabolites such as increased glycerol 3-phosphate and lactosylceramide were further identified. Both of them were significantly associated with maternal fasting blood glucose (FBG) level. Our findings may provide mechanistic clues for clarifying metabolic toxicity of PFOS in human, especially for susceptible population such as pregnant women.

Effects of Fetal Images Produced in Virtual Reality on Maternal-Fetal Attachment: Randomized Controlled Trial

Maternal-fetal attachment (MFA) has been reported to be associated with the postpartum mother-infant relationship. Seeing the fetus through ultrasound might influence MFA, and the effect could be increased by more realistic images, such as those generated in virtual reality (VR). The aim was to determine the effect of fetal images generated in VR on MFA and depressive symptoms through a prenatal-coaching mobile app. This 2-arm parallel randomized controlled trial involved a total of 80 pregnant women. Eligible women were randomly assigned to either a mobile app-only group (n=40) or an app plus VR group (n=40). The VR group experienced their own baby's images generated in VR based on images obtained from fetal ultrasonography. The prenatal-coaching mobile app recommended health behavior for the pregnant women according to gestational age, provided feedback on entered data for maternal weight, blood pressure, and glucose levels, and included a private diary service for fetal ultrasound images. Both groups received the same app, but the VR group also viewed fetal images produced in VR; these images were stored in the app. All participants filled out questionnaires to assess MFA, depressive symptoms, and other basic medical information. The questionnaires were filled out again after the interventions. Basic demographic data were comparable between the 2 groups. Most of the assessments showed comparable results for the 2 groups, but the mean score to assess interaction with the fetus was significantly higher for the VR group than the control group (0.4 vs 0.1, P=.004). The proportion of participants with an increased score for this category after the intervention was significantly higher in the VR group than the control group (43% vs 13%, P=.005). The feedback questionnaire revealed that scores for the degree of perception of fetal appearance all increased after the intervention in the VR group. The use of a mobile app with fetal images in VR significantly increased maternal interaction with the fetus. ClinicalTrials.gov NCT04942197; https://clinicaltrials.gov/ct2/show/NCT04942197.

Clinical benefit of dexmedetomidine in combination with dezocine as epidural anesthesia during cesarean delivery for pregnant women with gestational diabetes mellitus

Purpose: To investigate the clinical benefit of dexmedetomidine (DEX) when used in combination with dezocine as epidural anesthesia during cesarean delivery for puerperae with gestational diabetes mellitus (GDM).Methods: A total of 120 puerperae with GDM admitted to The Fourth Hospital of Shijiazhuang (Obstetrics and Gynecology Hospital Affiliated to Hebei Medical University, Shijiazhuang City, China) who underwent cesarean delivery from January 2019 to January 2020 were randomly assigned to groups A and B, with 60 patients per group. Epidural anesthesia with dezocine was used on patients in both groups, while DEX was added for patients in group A. Comparison was made between the 2 groups with regard to pregnancy outcomes, pain scores, maternal and infant blood glucose levels, hemodynamic indices, hormonal levels and adverse reaction rates (ARR).Results: Patients in group A had significantly better maternal and infant outcomes (p &lt; 0.05), lower maternal postoperative pain scores (p &lt; 0.05), lower maternal postoperative blood glucose levels (p &lt; 0.001), higher infant postoperative blood glucose levels (p &lt; 0.001). Furthermore, maternal incidence of adverse reactions in group A was lower than in group B (p &lt;0.05). At the time point of 0.5 h after anesthesia and operation, the hemodynamic indices of puerperae in group A were significantly more stable, and levels of estradiol and prolactin were higher, relative to those in group B (p &lt; 0.05). However, group A had a lower chemotaxin levels at immediate postoperative period and 1 day after operation than group B (p &lt; 0.05).Conclusion: The combination of DEX and dezocine for epidural anesthesia stabilizes hemodynamics, improves hormone levels and lowers the incidence of adverse reactions in puerperae with GDM, thereby potentially ensuring better pregnancy outcomes and well-controlled blood glucose levels. Therefore, this strategy for epidural anesthesia has potentials for use in clinical practice.

Association between Maternal Blood Glucose Levels during Pregnancy and Birth Outcomes: A Birth Cohort Study.

This study aimed to investigate the relationship between maternal blood glucose levels during pregnancy and neonatal birth outcomes in Northwest China. This population-based cohort study included 10,010 first-trimester pregnant women who joined the birth cohort of the Northwest Women's and Children's Hospital from July 2018 to July 2020. Basic demographic characteristics, lifestyle and behavior patterns were collected. Oral glucose tolerance test (OGTT) results during the second trimester and pregnancy outcomes after childbirth were also collected. A generalized linear model was constructed to analyze the effects of blood glucose levels on neonatal birth outcomes. We found that every 1 mmol/L increase in fasting plasma glucose (FPG) was associated with an increase in birth weight (β = 100.22 g, 95% confidence interval (95%CI): 81.91, 118.52), birth weight Z score (β = 0.23, 95%CI: 0.19, 0.27) and birth weight Z centile (β = 6.72%, 95%CI: 5.51, 7.94). Moreover, the risk of macrosomia, premature birth and being born large for gestational age (LGA) increased by 2.01 (95%CI: 1.67, 2.43), 1.35 (95%CI: 1.09, 1.66) and 1.80 (95%CI: 1.57, 2.07) times, respectively. Additionally, for every 1 mmol/L increase in FPG associated with a decrease in gestational age (β = -0.12 weeks, 95%CI: -0.19, -0.06), the risk of SGA decreased by 0.70 (OR = 0.70, 95%CI: 0.55, 0.89) times. Every 1 mmol/L increase in 1/2-h PG had similar outcomes as FPG, besides premature birth and SGA. Higher blood glucose in pregnant women may increase neonatal birth weight, decrease gestational age and lead to a higher risk of macrosomia, premature birth and LGA. Mothers should actively prevent and control hyperglycemia to promote maternal and infant health.

Correlation of Maternal Blood Glucose Level to Maternal Delivery and Fetal Outcome in Hasan Sadikin General Hospital

Increase of blood glucose level In pregnant woman correlated with increased risk of maternal morbidity, and problems in labour also affect child outcome. This phenomena cause by physiological changes occur in pregnancy such as placental factor and inflammation factor in circulation. Changes in inflammation factor like tumor nerosis factor (TNF-α) and beta-cell correlated gene disfunction (potassium voltage-gated channel KQT-like 1 (Kcnq1) and glucokinase (Gck)) could affect blood glucose level. Blood glucose control in pregnant woman known to be effective to decrease and prevent complication in mother and fetus, such as preeclampsia, prematurity, low birth weight, and asphyxia baby. This research wish to know correlation of maternal blood glucose level to maternal delivery and fetal outcome. This research use seconder data from medical records as retrospective cohort study. Subject of this study are pregnant mother which given birth in Hasan Sadikin Hospital (RSHS) sbetween January 2018 – December 2021 and has been performed blood glucose test when first time administered in Hasan Sadikin Hospital. Analitic statistic was performed with contingency correlation test, association test with chi-square and continued with multivariate logistic regression. From 8996 subjects, positive correlation was founded between high random blood glucose with preeclampsia (r=0.154, p&lt;0.001), premature labour (r=0.020, p=0.052), and low birth weight (r= -0.034, p=0.003). Correlation between random blood glucose and asphyxia was unfounded (r=0.003, p=0.809). There’s weak positive correlation between random blood glucose to preeclampsia and prematurity incidence. There’s also weak negative correlation between random blood glucose and baby birth weight. Correlation between blood glucose and APGAR score was unfounded.

Correlation of Maternal Blood Glucose Level to Maternal Delivery and Fetal Outcome in Hasan Sadikin General Hospital

Correlation of Maternal Blood Glucose Level to Maternal Delivery and Fetal Outcome in Hasan Sadikin General Hospital

Maternal fasting glucose levels throughout the pregnancy and risk of adverse birth outcomes in newborns: a birth cohort study in Foshan city, Southern China

We aimed to investigate the associations between maternal fasting plasma glucose (FPG) levels and glycemic fluctuations during different trimesters and adverse birth outcomes among newborns. This cohort study used data from 63 213 pregnant women and their offspring in Foshan city from November 2015 to January 2019. Associations between maternal FPG and glycemic fluctuations during different trimesters and adverse birth outcomes [congenital heart defect (CHD), macrosomia, small/large for gestational age (SGA/LGA), and preterm birth (PTB)] in newborns were estimated using mixed-effects logistic regression models. A total of 45 516 participants accepted at least one FPG test throughout pregnancy, and 7852 of whom had glycemic trajectory data. In the adjusted model, higher maternal FPG throughout the pregnancy was associated with an increased risk of adverse birth outcomes (except for SGA). Each 1 mmol/L increase in maternal FPG during trimester 1 was associated with higher odds of CHD (OR = 1.14 (95% CI: 1.02, 1.26)). The same increase in maternal FPG during trimester 3 was associated with a higher risk of PTB (OR = 1.05 (95% CI: 1.01, 1.10)). Increment of maternal FPG during trimester 2 and trimester 3 was associated with a higher risk of macrosomia and LGA. Increase in FPG throughout the pregnancy was associated with slightly lower odds of SGA. Similar results were observed when analyzing the associations between glycemic fluctuations during different trimesters and adverse birth outcomes. Our findings indicate higher maternal FPG levels during different trimesters were associated with different adverse birth outcomes, which suggests the importance of glycemic management throughout the pregnancy.

Evaluation of the relationship between neonatal serum asprosin levels and anthropometric measurements in newborns of mothers with and without gestational diabetes mellitus.

Asprosin is a newly identified adipokine that is expressed in the placenta. Its production is increased in women with gestational diabetes mellitus (GDM), and it is a factor related to insulin resistance. This study aimed to determine whether neonatal serum asprosin levels are associated with anthropometric characteristics of newborns born to mothers with and without GDM. This study included 51 newborns of mothers with GDM (insulin-treated or diet-treated) and 55 control newborns with their mothers. In newborns, anthropometric parameters were measured, and the concentrations of asprosin were detected by ELISA. Maternal blood glucose levels, body weight, and length were measured and body mass index (BMI) was calculated. Serum asprosin levels were significantly higher and linked to a higher risk in the newborns of mothers with GDM compared with those of the control newborns (170.3 [132.6] vs. 91.4 [68.7] ng/mL, p < 0.001). Serum asprosin levels were negatively correlated with blood glucose concentrations (r = -0.282, p = 0.045) in the newborns of mothers with GDM and significantly positively correlated with birth weight (r = 0.315, p = 0.019) in the control newborns. Newborn serum asprosin levels were positively correlated with the glucose levels (r = 0.264, p = 0.006) of all mothers. In addition, newborns born to an insulin-treated mother with GDM had significantly higher birth weight and length than newborns born to a diet-treated mother with GDM (3262.9 vs. 3137 g, p = 0.032, and 49.7 vs. 49.2 cm, p = 0.05). Although asprosin levels were higher in newborns of mothers treated with insulin, these differences were not statistically significant. Mothers with GDM had high blood glucose levels (p = 0.032). Serum levels of asprosin are increased and negatively correlated with glucose concentrations in newborns of mothers with GDM. Asprosin could be used as an early biomarker in newborns of GDM mothers.

Impacts of tocolytics on maternal and neonatal glucose levels in women with gestational diabetes mellitus

Impacts of tocolytics on maternal and neonatal glucose levels in women with gestational diabetes mellitus

Association between intrapartum glycemic control using continuous glucose monitoring and neonatal outcomes

ACOG recommends maintaining maternal euglycemia during labor to prevent neonatal hypoglycemia at birth; however, supporting data are limited. We evaluated the association between predelivery glycemic control using continuous glucose monitoring (CGM) and neonatal outcomes. Retrospective cohort study of patients with pregestational diabetes who used real-time CGM and delivered a live, singleton at a tertiary care center (9/2018-7/2022). Patients with major fetal anomalies were excluded. Glycemic control was measured by CGM, and time spent in target range (TIR) of 65-140mg/dL was calculated for 6hr before delivery. The primary outcome was neonatal hypoglycemia (initial glucose < 40mg/dL). Secondary outcomes included hypoglycemia requiring treatment, initial glucose, hyperbilirubinemia, NICU admission and length of stay. Baseline characteristics and outcomes were compared between patients with TIR >70% vs TIR ≤70%. Multivariable regression estimated the association between TIR >70% and outcomes. In sensitivity analyses, we varied the exposure definition to TIR 12hr and 2hr before delivery. Of 53 included patients, 42 (79%) had TIR >70% and 11 (21%) had TIR≤70%. Patients with TIR >70% were more likely to have type 2 diabetes and higher BMI (Table 1). Neonatal hypoglycemia was less common among patients with TIR >70% compared to TIR≤70%, but it was not statistically significant (24% vs 36%, aOR 0.52, 95% CI 0.11-2.50; Table 2). Other outcomes were also similar between groups. In sensitivity analyses, there was no association between TIR >70% during 12hr before delivery and hypoglycemia (aOR 0.28, 95% CI 0.07-1.07); however, TIR >70% during 2hr before delivery was associated with a lower odds of hypoglycemia (aOR 0.01, 95% CI 0.02-0.80). Maternal glycemic control immediately before delivery appears to be more important for prevention of neonatal hypoglycemia in patients with pregestational diabetes. Use of CGM data should be considered in future studies to better understand the optimal maternal glucose level and timing before delivery to minimize neonatal hypoglycemia.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Early emergence of sexual dimorphism in offspring leukocyte telomere length was associated with maternal and children’s glucose metabolism—a longitudinal study

BackgroundLeukocyte telomere length (LTL) is suggested to be a biomarker of biological age and reported to be associated with metabolic diseases such as type 2 diabetes. Glucose metabolic traits including glucose and insulin levels have been reported to be associated with LTL in adulthood. However, there is relatively little research focusing on children’s LTL and the association with prenatal exposures. This study investigates the relationship between maternal and offspring glucose metabolism with offspring LTL in early life.MethodsThis study included 882 mother-child pairs from the HAPO Hong Kong Field Centre, with children evaluated at age 7.0 ± 0.4 (mean ± SD) years. Glucose metabolic traits including maternal post-load glucose during pregnancy, children’s glucose and insulin levels, and their derived indices at follow-up were measured or calculated. Offspring LTL was assessed using real-time polymerase chain reaction.ResultsSex- and age-adjusted children’s LTL was found to be associated with children’s HOMA-IR (β=−0.046 ± 0.016, p=0.005). Interestingly, both children’s and maternal post-load glucose levels were positively associated with children’s LTL. However, negative associations were observed between children’s LTL and children’s OGTT insulin levels. In addition, the LTL in females was more strongly associated with pancreatic beta-cell function whilst LTL in males was more strongly associated with OGTT glucose levels.ConclusionsOur findings suggest a close association between maternal and offspring glucose metabolic traits with early life LTL, with the offspring sex as an important modifier of the disparate relationships in insulin production and response.