Non-diabetic Mothers Research Articles

Cardiac Troponin-I Level at 24 hours of Age in Stable Newborn Infants Born at ≥35 Weeks of Gestation.

Cardiac troponin-I is a known biomarker of myocardial injury in adults and children but its diagnostic utility is unclear in newborns.This study aimed to establish normative data for troponin-I in stable newborns and assess any variation due to maternal diabetes status, mode of delivery, and Apgar scores. Prospective, observational study of stable newborn ≥35 weeks gestation admitted to a well-baby nursery at a single institution. Infants with respiratory distress, congenital infections, malformations, or syndromes were excluded. Troponin-I values were obtained by a validated point-of-care capillary blood sample at 24 hours of age. A total of 132 patients were included for analysis. Thirteen infants were born to mothers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy and analyzed as a subgroup, with the remaining 119 infants comprising the base cohort to establish baseline normative troponin-I levels in stable newborn infants. The mean (standard deviation) troponin-I level of infants in the base cohort group was 0.019 ± 0.018 ng/mL and in infants born with maternal SARS-CoV-2 infection during pregnancy troponin-I level was 0.081 ± 0.1 ng/mL (p < 0.001). In infants of the base cohort, there was no significant difference in troponin-I levels between diabetic versus nondiabetic mothers, vaginal birth versus cesarean section, and 5-minute Apgar score of <7 versus ≥7. Cardiac troponin-I level in healthy term newborns was 0.019 ± 0.018 ng/mL, which conforms to healthy children and adult lab values. There was no statistically significant difference in troponin-I levels in infants of maternal diabetes or normal glucose status, mode of delivery, cesarean versus vaginal, or 5-minute Apgar score of <7 or ≥7. Troponin-I levels in asymptomatic neonates born to mothers with a history of SARS-CoV-2 during pregnancy demonstrated an elevation when compared to the baseline group of infants. · Troponin-I level, biomarker of myocardial injury, in newborns not requiring delivery-room.. · Resuscitation is comparable to normal pediatric & adult population independent of mode of delivery or maternal diabetes status..

Cord Blood Metabolic Markers as Mediators of the Effect of Maternal Adiposity on Fetal Growth in Diabetic and Non-diabetic Mothers

Cord Blood Metabolic Markers as Mediators of the Effect of Maternal Adiposity on Fetal Growth in Diabetic and Non-diabetic Mothers

M Mode Assessment of Fetal Interventricular Septal Thickness in Third Trimester with Comparison Between Diabetic and Non-Diabetic Mothers

Background: Babies born to diabetic mothers face increased risks of illness and death despite advances in prenatal care. One common heart defect in these babies is interventricular septal hypertrophy. Objective: This study examines how gestational diabetes affects fetal interventricular septal thickness (IVST). Material &amp; Methods: The study took place at Sharda Hospital's Radiology Department over two months. Ninety pregnant women between 28 and 35 weeks of gestation were selected. The women were grouped based on oral glucose tolerance test (OGTT) results into non-diabetic (Subgroup A), controlled diabetic (Subgroup B), and uncontrolled diabetic (Subgroup C). IVST measurements were taken using M-mode during diastole. Results: The average age of participants was 26.41±3.18 years. In the 28-32 week group, the mean IVST was 3.76±0.23mm for non-diabetic women, 4.00±0.28mm for controlled diabetics, and 5.83±0.64mm for uncontrolled diabetics. In the 32-35 week group, the mean IVST was 4.25±0.29mm for non-diabetics, 4.75±0.43mm for controlled diabetics, and 6.84±0.34mm for uncontrolled diabetics. IVST was significantly higher in uncontrolled diabetics (p&lt;0.05), while non-diabetic and controlled diabetic groups had similar thicknesses. There was a significant positive correlation between OGTT levels and IVST (p&lt;0.05). Conclusion: Fetal IVST was notably higher in uncontrolled diabetic mothers. There is a strong association between OGTT results and IVST. M-mode measurement of IVST is simpler than fetal echocardiography and can be included in routine third-trimester scans for diabetic mothers to detect early signs of hypertrophic cardiomyopathy.

A 10-Year Retrospective Study: Is Maternal Diabetes a Risk Factor for Associated Anomalies in Males With Cryptorchidism?

Background and objective Cryptorchidism, or undescended testes (UDT), refers to the failure of one or both testicles to descend to their natural position in the scrotum of newborn males. The association of gestational diabetes with cryptorchidism has not been studied sufficiently. Hence, this study aimed to analyze the association between maternal diabetes and cryptorchidismand other associated anomalies among Jordanian male children. Methods We conducted a retrospective studyinvolving women and their cryptorchid offspring over a 10-year period, between January 2010 and December 2019. The data were collected using a retrospective review of the hospital records and questionnaires administered via phone calls. We included all patients with cryptorchidism and excluded children with a diagnosis of disorders of sexual development. Results A total of 368 children with cryptorchidism were included, with 29 mothers suffering from gestational or type II diabetes at the time of pregnancy. About 25% of patients suffered from associated anomalies, the most common being genital anomalies, while hypospadias was the most common associated anomaly. We observed no differences in terms of the age of diagnosis or treatment of cryptorchidism between children born to diabetic and those born to nondiabetic mothers. Conclusions Diabetic mothers have a higher chance of having offspring with anomalies that might co-occur with cryptorchidism, particularly urogenital anomalies. Further research is needed to explore the link between maternal diabetes and these abnormalities. Screening for gestational diabetes is critical, and more extensive studies could provide clearer recommendations for screening protocols and early intervention.

Therapeutic effect of Momordica charantia on cardiomyopathy in a diabetic maternal rat model.

Myocardial structural and functional abnormalities are hallmarks of diabetic cardiomyopathy (DCM), a chronic consequence of diabetes mellitus (DM). Maternal DM affects and increases the risk of heart defects in diabetic mothers compared with nondiabetic mothers. Momordica charantia exhibits antidiabetic effects due to various bioactive compounds that are phytochemicals, a broad group that includes phenolic compounds, alkaloids, proteins, steroids, inorganic compounds, and lipids. Pregnant maternal rats were split into four groups: control (C), M. charantia-treated (MC), type 2 diabetes mellitus (T2DM) (DM), and diabetic (MC + DM) groups. Diabetes mothers had increased serum glucose, insulin, total cholesterol, triglyceride, and low-density lipoprotein cholesterollevels and reduced high-density lipoprotein cholesterollevels. Cardiac biomarkers such as cardiac troponin T (cTnT), creatine kinase-myocardial band (CK-MB), and lactate dehydrogenasewere increased. Hormone levels of follicle-stimulating hormone, luteinizing hormone, progesterone, and estrogen decreased significantly. Inflammatory markers such as interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), and vascular adhesion molecule-1 (VCAM-1) were elevated in diabetic mothers. Oxidative stress markers indicated increased malondialdehydeand nitric oxidelevels, while antioxidants such as glutathione, superoxide dismutase, and catalasewere decreased in maternal heart tissue. The levels of apoptotic markers such as tumor suppressor 53 (P53) and cysteine aspartic protease-3 (caspase-3) were significantly greater in diabetic maternal heart tissue. Histopathological analysis revealed heart tissue abnormalities in diabetic maternal rats. M. charantia extract improved maternal diabetes-induced changes in inflammation, antioxidant levels, and heart tissue structure.

Association of Umbilical Cord Perilipin 2 Levels with Neonatal Anthropometric Measurements in Infants of Diabetic Mothers.

Perilipin 2 (PLIN2) is a protein that contributes to the formation and stability of lipid droplets. It has been associated with the development of several diseases, particularly related to glucose and lipid metabolism. In infants of diabetic mother (IDM), fetal hyperinsulinaemia leads to increased adipose tissue and macrosomia. The aim of this study was to investigate the relationship between PLIN2 levels and anthropometric measurements in the IDM and to investigate the relationship between PLIN2 levels and IGF-1, IGF-2 and leptin levels. The study group consisted of IDMs, while the control group consisted of infants born to non-diabetic mother, matched for gestational week and gender. Cord blood samples were collected from all patients to determine PLIN2, IGF-1, IGF-2 and leptin levels. Anthropometric measurements were taken for all patients at birth. There were no differences between the groups in birth weight, birth length, head circumference and body mass index (BMI), but middle arm circumference, triceps, biceps, subscapular and suprailiac skinfold thickness were significantly higher in the IDM. While PLIN2, IGF-1, IGF-2 and leptin levels were similar between groups, there was a strong correlation between PLIN2 levels and IGF-2 and leptin levels. Even if IDMs were not macrosomic, the presence of high subcutaneous adipose tissue was not associated with PLIN2.

Postnatal growth and weight gain in term and near-term infants with severe neonatal hypoglycemia: a comparison between offspring of diabetic and non-diabetic mothers

Postnatal growth and weight gain in term and near-term infants with severe neonatal hypoglycemia: a comparison between offspring of diabetic and non-diabetic mothers

Epicardial fat thickness among neonates of diabetic mothers attending the neonatal intensive care unit at Fayoum University Hospital: a case control study

BackgroundUsing conventional echocardiography, this study aimed to evaluate the epicardial fat thickness (EFT) and its role in discriminating infants of diabetic mothers (IDMs) from those of non-diabetic mothers (INDMs) and to assess its prognostic role in IDMs. This case control study was conducted at the Neonatology and Cardiology Units of Pediatric Department, Fayoum University Hospital, Egypt, between February and September 2023. A total of 54 neonates were enrolled into three groups: 18 IDMs with well-controlled diabetes mellitus (DM), 18 IDMs with poorly controlled DM, and 18 INDMs.ResultsThe sensitivity, specificity, and cutoff of EFT were 100%, 100%, and 3.950 mm for detecting cases of IDMs and were 66.7%, 72.2%, and 5.100 mm for differentiating controlled from uncontrolled diabetic mothers, respectively. The interventricular septum in diastole (IVSd), interventricular septum in systole (IVSs), estimated pulmonary artery pressure (PAP), left ventricle (LV) Tei index, and isovolumetric relaxation time (IVRT) of LV all showed a positive correlation with EFT (r = 0.35, 0.31, 0.41, 0.34, and 0.39; P = 0.009, 0.025, 0.002, 0.01, and 0.003; respectively). There was a significant negative correlation between EFT and left ventricular internal dimensions in diastole (LVIDd) and left ventricular internal dimensions in systole (LVIDs) (r = − 0.44 and 0.42, P = 0.001 and 0.001). Regarding tissue Doppler, there was a significantly higher Tei index in group I cases compared to control (0.59 ± 0.10 vs. 0.49 ± 0.09, P < 0.001).ConclusionsThe EFT is higher in IDMs than in INDMs, with a positive correlation with birth weight, IVSd, IVSs, Tei index of mitral, IVRT, and ESPAP and a negative correlation with LVIDd and LVIDs. Neonatal EFT can be used as one of the helpful parameters to detect IDMs. Also, it may be used as one of the prognostic factors in IDMs as it is positively correlated with the diastolic function of the LV.

Maternal Obesity Modulates Cord Blood Concentrations of Proprotein Convertase Subtilisin/Kexin-type 9 Levels.

In utero exposure to maternal obesity or diabetes is considered a pro-inflammatory state. To evaluate whether cord blood proprotein convertase subtilisin/kexin-type 9 (PCSK9), which is regulated by inflammation and metabolic derangements, is elevated in neonates born to overweight, obese, or diabetic mothers. A retrospective study in full-term neonates born between 2010 and 2023, at Brigham and Women's Hospital. There were 116 neonates included in our study, of which 74 (64%) were born to overweight/obese mothers and 42 (36%) were born to nonoverweight/nonobese mothers. Neonates born to overweight/obese mothers had significantly higher cord blood concentrations of PCSK9 compared with neonates born to nonoverweight/nonobese group (323 [253-442] ng/mL compared with 270 [244-382] ng/mL, P = .041). We found no significant difference in cord blood concentrations of PCSK9 between neonates of diabetic mothers compared with neonates of nondiabetic mothers. In multivariate linear regression analysis, higher cord plasma PCSK9 concentration was significantly associated with maternal overweight/obesity status (b = 50.12; 95% CI, 4.02-96.22; P = .033), after adjusting for gestational age, birth weight, male sex, and intrauterine growth restriction. Neonates born to mothers with overweight/obesity have higher cord blood PCSK9 concentrations compared with the nonoverweight/nonobese group, and higher cord blood PCSK9 concentrations were significantly associated with maternal overweight/obesity status, after adjusting for perinatal factors. Larger longitudinal studies are needed to examine the role of PCSK9 in the development of metabolic syndrome in high-risk neonates born to overweight, obese, or diabetic mothers.

Pregnancy Outcomes in Diabetic Mothers with Controlled Glycemia: A Case-Control Study

Background: Overt Diabetes mellitus and Gestational diabetes mellitus (GDM) can complicate pregnancy. Early detection and management of the disease should be done to ensure better maternal and foetal outcomes. Our goal is to compare treatment-controlled diabetic women with non-diabetic women to evaluate the pregnancy-related unfavourable outcomes. Methods and Materials: This is a single-centre case-control study with women, from Nellore, Andhra Pradesh, who gave birth between September 2022 and February 2023. A total of 144 patients, including 72 women with diabetes and controlled glycemia (case group, n=72), were compared with non-diabetic women (control group, n=72). Various pregnancy-related outcomes were observed. The student t-test and SPSS were used for statistical analysis to compare Results: Average ages were 24±4.9 years and 27.83±6.24 years in controls and cases, respectively. Mean pregnancy duration was 268.15±7.1 days in controls and 257.1±31.2 days in cases. The cases had a mean HbA1C of 6.05%, indicating controlled levels. Caesarean births were observed in 75% of cases and 51.3% of controls. While macrosomia (&gt;4 kg) was not observed, 25% of cases had low birth weight (&lt;2.5 kg). Family history, gravidity, consanguinity, newborn sex, APGAR score, nuchal cord, asphyxia, and need for respiratory support did not significantly differ between the cases and controls. However, there was a significant difference (p&lt;0.05) in the gestation period, previous neonatal loss, type of previous deliveries, caesarean delivery, baby weight, hyperbilirubinemia, and present neonatal loss between diabetic mothers and non-diabetic mothers. Conclusion: A well-managed chronic hyperglycaemia was thought to prevent multiple pregnancy-related problems for both the mother and the baby. This study aimed to investigate this point. Though many complications were avoided with controlled glycemia in our study, complications such as caesarean deliveries, preterm births, low birth weight, hyperbilirubinemia, and neonatal loss were more prevalent in cases. This highlights the need for further research, especially in understanding and possibly intensifying glycaemic goals for diabetic mothers.

The effect of maternal weight on neonatal cardiac functions following diabetic and non-diabetic pregnancies.

We aimed to study myocardial functions of infants appropriate and large for gestational age (IDM-AGA, IDM-LGA) of diabetic mothers (IDM) and AGA and LGA infants of non-diabetic mothers comparatively. Newborns were assessed between 24 and 72 h. M-Mode, pulsed wave, and tissue Doppler echocardiography were performed. A negative correlation was found between shortening fraction and maternal weight at delivery in the LGA group (p=0.009, r=-0.58). E/Early diastolic (E') ratio and deceleration time were increased in IDM-AGA than AGA group (p=0.02, p=0.02). There was a negative correlation between maternal blood glucose and E/A ratio (p=0.015 r=-0.63), a positive correlation between maternal blood glucose and mitral A, late diastolic (A') wave in IDM-AGA (p=0.014 r=0.63, p=0.016 r=0.62). Maternal weight gain during pregnancy was in correlation with measured and tei index in IDM-AGA group (p=0.008 r=0.72). Maternal age, pre-pregnancy weight, and weight at delivery and mitral E were higher in IDM-LGA group than IDM-AGA (p=0.03, p=0.01, p=0.003, p=0.012). We found that maternal weight has a negative effect on myocardial function in LGA newborns. Diastolic functions were found impaired in IDM-AGA infants and in infants of mothers with high blood glucose. Maternal weight gain during pregnancy has a negative effect on myocardial functions.

Comparison of Perinatal Complications in Macrosomic İnfants of Diabetic and Nondiabetic Mothers

Introduction: Metabolic, congenital disorders, and complications seen in infants of diabetic mothers (IDM) are well defined in the literature. We aimed to compare perinatal problems in macrosomic IDM and infants of mothers without diabetes.&#x0D; Methods: We included all macrosomic infants admitted to neonatal intensive care unit (NICU) at two centers between 2017-2020. Birth history, anthropometric measurements, gestational age, metabolic and cardiac problems were compared between macrosomic IDMs and infants of non-DMs. The p-value less than 0.05 was considered statistically significant.&#x0D; Results: 156 (37 IDM, and 119 non-IDM) macrosomic newborns were included in the study. While the incidence of hypoglycemia, need for mechanical ventilation, respiratory distress syndrome, ventricular septal defect (VSD) and persistent pulmonary hypertension (PPH) were statistically similar, the incidence of cesarean section (p=0.002), myocardial hypertrophy (p=0.001), and polycythemia (p=0.019) was higher in the IDM group. While the incidence of respiratory problems and VSD was similar in both groups, myocardial hypertrophy was found in approximately in one fourth (22.2%) of the non-diabetic group.&#x0D; Conclusion: Macrosomic non-IDMs have a similar risk for perinatal-postnatal complications as macrosomic IDMs and should be evaluated accordingly.

Sacral agenesis without maternal diabetes: a case report.

Sacral agenesis is a rare congenital condition that is characterized by sacrococcygeal bone agenesis. It is associated with spinal cord anomalies as well as problems with the genitourinary system, large bowel, and lower extremities. Fetal ultrasound allows for diagnosis even before birth. The authors present the case of a 1-year-old girl with sacral agenesis type III and bilateral congenital talipes equinovarus with spina bifida who was born to a nondiabetic mother and had a normal anomaly scan. People with less severe forms of sacral agenesis can live a normal life, and it is not connected with cognitive impairment; however, concomitant bladder, colon, and lower limb disorders cause considerable morbidity. The majority of treatment is supportive, frequently requiring orthopedic, urological, gastroenterological, pediatric, and physiotherapy support. Genetic and prepregnancy counseling, as well as early screening of high-risk mothers, remain the only options for prevention of the disease since treatment is mostly supportive.

Sardinian Infants of Diabetic Mothers: A Metabolomics Observational Study.

Gestational diabetes mellitus (GDM) is a condition characterized by glucose intolerance, with hyperglycemia of varying severity with onset during pregnancy. An uncontrolled GDM can lead to an increased risk of morbidity in the fetus and newborn, and an increased risk of obesity or developing type 2 diabetes, hypertension or neurocognitive developmental impairment in adulthood. In this study, we used nuclear magnetic resonance (NMR) spectroscopy and gas chromatography-mass spectrometry (GS-MS) to analyze the urinary metabolomic profile of newborns of diabetic mothers (NDMs) with the aim of identifying biomarkers useful for the monitoring of NDMs and for early diagnosis of predisposition to develop related chronic diseases. A total of 26 newborns were recruited: 21 children of diabetic mothers, comprising 13 in diet therapy (NDM-diet) and 8 in insulin therapy (NDM-insulin), and 5 control children of non-diabetic mothers (CTR). Urine samples were collected at five time points: at birth (T1), on the third day of life (T2), one week (T3), one month (T4) and six months postpartum (T5). At T1, variations were observed in the levels of seven potential biomarkers (acetate, lactate, glycylproline/proline, isocitrate, N,N-dimethylglycine, N-acetylglucosamine and N-carbamoyl-aspartate) in NMD-insulin infants compared to NDM-diet and CTR infants. In particular, the altered metabolites were found to be involved in several metabolic pathways such as citrate metabolism, glycine, serine and threonine metabolism, arginine and proline metabolism, amino sugar and nucleotide sugar metabolism, and pyruvate metabolism. In contrast, these changes were not visible at subsequent sampling times. The impact of early nutrition (maternal and formula milk) on the metabolomic profile was considered as a potential contributing factor to this finding.

The spectrum of congenital heart defects in neonates of diabetic mothers

Introduction: Insulin-dependent diabetes mellitus (IDDM) in a mother is considered a risk factor for congenital malformation, including congenital heart diseases. Many studies signify a five to six times increased frequency of congenital heart diseases in neonates born from insulin-dependent diabetic mothers. This study aimed to identify the spectrum of congenital heart diseases (CHDs) in neonates born from insulin-dependent diabetes mellitus (IDDM) mothers. Methods: Between April 2019 and March 2021, a descriptive cross-sectional study involved 120 consecutive neonates aged 0-28 days of mothers with insulin-dependent diabetes mellitus (IDDM) at Maiwand Teaching Hospital, Kabul University of Medical Sciences. Neonates born to non-diabetic mothers were excluded. IDDM refers to mothers using Insulin upon admission to control blood glucose. CHD encompasses various heart defects affecting function. Family and maternal history were noted, focusing on health issues and delivery details. Neonatal mothers' ages ranged from 23 to 45 (mean 33), with diabetes onset spanning 2.5 to 25 years. Pediatric cardiologists conducted physical and echocardiographic exams. All CHD forms were documented using 2D echocardiography and Doppler studies (Sono Ace X-6 Machine). Result: 120 consecutive neonates born to mothers with insulin-dependent diabetes mellitus (IDDMs) were investigated during the two-year study period. Of them, 18 (15%) had congenital heart abnormalities. The prevalence of solitary and multiple CHD was 66.6 percent (12 patients) and 33.3 percent (6 patients) in the 18 infants born from IDDMs. The most prevalent isolated defects were PDA (22.2%) and Ventricular septal defect (16.6%). The most common multiple CHDs (16.6 percent) were PDA and ASD. PDA + ASD (16.6%) and VSD + PDA were the most frequent correlations with CHD (11.1 percent). Conclusion: Maternal insulin-dependent diabetes mellitus is an important risk factor for congenital heart disease. Careful assessment and early diagnosis of CHD in this high-risk group are very important in a pediatric population. Expansion of prenatal screening programs for CHDs in mothers suffering from insulin-dependent diabetes mellitus is necessary. Keywords: congenital heart diseases; diabetic mothers; insulin dependent; neonates

Cardiovascular anomalies in infants born to diabetic mothers: A study at a Tertiary Care Hospital.

Objective: To find out the frequency of cardiovascular anomalies in infants born to diabetic mothers (IDMs). Study Design: Case-control study. Setting: Department of Pediatric Medicine and the Department of Obstetrics &amp; Gynecology, Rai Medical College / Teaching Hospital, Sargodha. Period: January 2022 to December 2022. Material &amp; Methods: A total of 50 term IDMs were enrolled in case group while equal number of healthy infants (n=50) were enrolled as controls. All mothers received prenatal care. Standard diagnostic criteria were followed for labeling diabetes and gestational diabetes. All infants underwent detailed physical and clinical examination. Demographic and maternal characteristics along with perinatal and maternal information were noted. All infants underwent echocardiographic evaluation. Results: In a total of 100 infants, 51 (51.0%) were boys and 49 (49.0%) girls. The mean birth weight, Apgar score (at 5-minutes), maternal age and gestational age were 2.84±1.8 kg, 8.8±0.7, 29.5±3.2 and 37.4±1.8 weeks respectively. Maternal hypertension was observed among 12 (12.0%) subjects. Birth weight (p&lt;0.0001), maternal age (p=0.0129) and gestational age (p=0.0110) were significantly higher among cases while Apgar score was significantly lower among cases in comparison to controls (p=0.0028). Cardiovascular anomalies were diagnosed in 10 (20.0%) cases in comparison to 3 (6.0%) controls and the difference was found to be statistically significant. Among IDMs, hypertrophic cardiomyopathy (HCM) was the most frequent cardiovascular anomaly, noted in 4 (8.0%) cases. Conclusion: The frequency of cardiovascular anomalies was significantly high among IDMs in comparison to infants born to non-diabetic mothers. IDMs should undergo cardiac examination to rule out the possibility of existing cardiovascular anomalies.

Mediation effect of maternal triglyceride and fasting glucose level on the relationship between maternal overweight/ obesity and fetal growth: a prospective cohort study

BackgroundPrevious studies have suggested that maternal overweight/obesity is asscociated with macrosomia. The present study aimed to investigate the mediation effects of fasting plasma glucose (FPG) and maternal triglyceride (mTG) in the relationship between maternal overweight/obesity and large for gestational age (LGA) among non-diabetes pregnant women.MethodsThis prospective cohort study was conducted in Shenzhen from 2017 to 2021. A total of 19,104 singleton term non-diabetic pregnancies were enrolled form a birth cohort study. FPG and mTG were measured at 24–28 weeks. We analyzed the association of maternal prepregancy overweight/obesity with LGA and mediation effects of FPG and mTG. Multivariable logistic regression analysis and serial multiple mediation analysis were performed. The odds ratio (OR) and 95% confidence intervals (CIs) were calculated.ResultsMothers who were overweight or obese had higher odds of giving birth to LGA after adjusting potential confounders (OR:1.88, 95%CI: 1.60–2.21; OR:2.72, 95%CI: 1.93–3.84, respectively). The serial multiple mediation analysis found prepregnancy overweight can not only have a direct positive effect on LGA (effect = 0.043, 95% CI: 0.028–0.058), but also have an indirect effect on the LGA through two paths: the independent mediating role of FPG (effect = 0.004, 95% CI: 0.002–0.005); the independent mediating role of mTG (effect = 0.003,95% CI: 0.002–0.005). The chain mediating role of FPG and mTG has no indirect effect. The estimated proportions mediated by FPG and mTG were 7.8% and 5.9%. Besides, the prepregnancy obesity also has a direct effect on LGA (effect = 0.076; 95%CI: 0.037–0.118) and an indirect effect on LGA through three paths: the independent mediating role of FPG (effect = 0.006; 95%CI: 0.004–0.009); the independent mediating role of mTG (effect = 0.006; 95%CI: 0.003–0.008), and the chain mediating role of FPG and mTG (effect = 0.001; 95%CI: 0.000-0.001). The estimated proportions were 6.7%, 6.7%, and 1.1%, respectively.ConclusionThis study found that in nondiabetic women, maternal overweight/obesity was associated with the occurence of LGA, and this positive association was partly mediated by FPG and mTG, suggesting that FPG and mTG in overweight/obese nondiabetic mothers deserve the attention of clinicians.

Influence of maternal hyperglycemia on rat daughters and granddaughters

This study evaluated the influence of maternal diabetes on the reproductive outcomes of adult daughters during full-term pregnancy in rats. The local ethics committee approved all experimental protocols. The adult female pups of nondiabetic (control – CP) and diabetic (DP) mothers were subjected to mating with healthy male rats for reproductive analysis. On day 17 of pregnancy, both groups underwent an oral glucose tolerance test (OGTT) to evaluate glucose tolerance. At the end of pregnancy, the rats were anesthetized for laparotomy and exposure of maternal organs. Uterine horns, ovaries, fetuses, and placentas were weighed to classify fetal weight and placental efficiency. P&lt;0.05 was considered a statistically significant limit, and Pearson's correlation was used. Higher maternal fasting blood glucose was correlated with a lower number of live fetuses and, consequently, with a lower litter weight. Thus, maternal fasting glucose during pregnancy is a relevant biomarker related to the poor reproductive outcome of daughters of rats. Furthermore, these findings show the detrimental effects of fetal programming induced by maternal diabetes in adulthood in the subsequent generation.

Assessment of fetal thymus size and BMI in pregnant women with diabetes.

The purpose of this study is to demonstrate whether diabetes during pregnancy affects the development of the fetal immune system. The background: evaluation of potential complications in diabetic pregnancy. The objective is evaluation of the significance of a new ultrasound method of thymus size in pregnancies complicated by diabetes. The analysis was performed with the use of IBM SPSS Statistics 25.0 software. The Mann-Whitney U test was used for comparison of two groups, i.e., diabetic pregnancies and non-diabetic pregnancies, whereas Kruskal-Wallis H test was used to compare multiple groups. A linear regression model was used to determine the correlation between the type of diabetes and fetal thymus size as well as between maternal body mass index (BMI) and fetal thymus size. The significance level α was set at 0.05. A comparison between diabetic and non-diabetic pregnancies was made with the use of Kruskal-Wallis H test. The compared groups included women without gestational diabetes, with pre-gestational diabetes, gestational diabetes managed by diet and gestational diabetes treated with insulin and diet. The analysis revealed significant differences between the compared groups, H (3) = 23.06; p < 0.001; ƞ2 = 0.04. The additional post hoc Dunn's test with Bonferroni correction of the significance level was used to explore specific differences between group means. The results of this detailed analysis indicated that foetuses of diabetic mothers treated with diet had smaller thymus than foetuses of non-diabetic mothers (p = 0.001). Linear regression analysis was used to establish whether maternal BMI (defined as the body mass divided by the square of the body height and expressed in units of kg/m²) affects fetal thymus size. The analysis found no correlation between maternal BMI divided into the following categories: 18.5-24.99 normal weight, 25-29.99 overweight, 30.00-34.99 obese class I, 35.00-39.99 obese class II and ≥ 40.00 very severely obese, and fetal thymus size, b = -1.82; SE = 2.17; t = -0.84; p = 0.405; R2 < 0.01. Thymus size is statistically smaller in foetuses of diabetic mothers when compared to healthy controls. Overweighted and obese pregnancy is not a factor affecting fetal thymus size.

Exposure to Maternal Diabetes during Pregnancy Is Associated with Aggravated Short-Term Neonatal and Neurological Outcomes following Perinatal Hypoxic-Ischemic Encephalopathy.

Infants of diabetic mothers (IDM) are at higher risk of perinatal morbidities and glycemic instability, but the impact of maternal diabetes on neonatal and neurological short-term outcomes of neonates with hypoxic-ischemic encephalopathy (HIE) remains poorly described. Our objective was to determine the impact of maternal diabetes on neonatal and neurological short-term outcomes following neonatal HIE. This was a retrospective single-center study including 102 term neonates with HIE who received therapeutic hypothermia (TH) treatment between 2013 and 2020. Multiple regression analysis was used to assess the relationship between the presence of maternal diabetes and short-term outcomes. Neonates with HIE and maternal diabetes exposure had a significantly lower gestational age at birth (38.6 vs. 39.7 weeks of gestation, p = 0.005) and a significantly higher mean birth weight (3,588 ± 752 vs. 3,214 ± 514 g, p = 0.012). IDM with HIE were ventilated for longer duration (8 vs. 4 days, p = 0.0047) and had a longer neonatal intensive care unit (NICU) stay (18 vs. 11 days, p = 0.0483) as well as took longer time to reach full oral feed (15 vs. 7 days, p = 0.0432) compared with neonates of nondiabetic mother. Maternal diabetes was also associated with an increased risk of death or abnormal neurological examination at discharge in neonates with HIE (odds ratio: 6.41 [1.54-26.32]). In neonates with HIE, maternal diabetes is associated with an increased risk of death or short-term neonatal morbidities, such as longer duration of ventilation, prolonged neonatal stay, greater need for tube feeding, and being discharged with an abnormal neurological examination. Strategies to prevent, reduce, or better control maternal diabetes during pregnancy should be prioritized to minimize complications after perinatal asphyxia. · Maternal DB is associated with unfavorable outcomes.. · IDM have longer ventilatory support and tube feeding.. · IDM have higher risk of abnormal neurological examination..