Affiliations: Faculty of Medicine, Pediatrics Department, Ain Shams University, Cairo, Egypt | Faculty of Medicine, Clinical Pathology Department, Ain Shams University, Cairo, Egypt
Note: [] Corresponding author: Dr. Rania A. El-Farrash, Faculty of Medicine, Pediatrics Department, Ain Shams University, Cairo, 13 Abd el-Aziz Talaat Harb St., Nasr City, 11351 Cairo Egypt. Tel.: +20 2 0122208550; Fax: +20 502246781; E-mail: raniafarrash@hotmail.com
Abstract: Background: Diabetes is recognized as a particular threat to pregnant women and their neonates. B-type natriuretic peptide (BNP) and N-terminal-proBNP play an important role in the regulation of extracellular fluid volume and blood pressure. BNP inhibits myocardial fibrosis and hypertrophy. Aim: To test the hypothesis that cord blood NT-proBNP would be increased in infants of diabetic mothers (IDMs) and linking its concentration to the degree of maternal glycemic control. Subjects and methods: This case control study was conducted on 85 full term neonates born at the Obstetrics and Gynecology department at Ain-Shams University Hospitals. The studied neonates were classified into 3 groups; Group I (n = 30) included IDMs with good maternal glycemic control (HbA1c <6%), group II (n = 25) included IDMs with suboptimal maternal glycemic control (HbA1c ≥6%) and healthy control group (n = 30). The included mothers/infants dyads were subjected to detailed history taking, thorough clinical examination and laboratory investigations which included maternal HbA1c and cord blood NT-proBNP. Results: Cord blood NT-proBNP levels were higher in IDMs with suboptimal maternal glycemic control than those born to healthy mothers, while NT-proBNP levels were comparable between neonates with good maternal glycemic control and healthy controls. NT-proBNP levels were higher in IDMs with suboptimal maternal glycemic control than those born to mothers with good glycemic control. NT-proBNP showed significant correlations with maternal HbA1c and one minute Apgar score. Conclusions: Neonatal NT-BNP concentrations are related to maternal glycemic control and perinatal hypoxia. In infants born to mothers with suboptimally controlled diabetes, NT-proBNP increases.
Keywords: Infants of diabetic mothers, NT-proBNP, glycosylated hemoglobin, maternal glycemic control
