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Cord plasma glucose and insulin concentrations and maternal-fetal relations
Insights
Umbilical cord blood plasma revealed that 10% of infants had high insulin levels (≥12 muU./ml.). Intravenous fluids and vaginal birth were associated with lower insulin concentrations, suggesting stress is not a cause.
Area of Science:
- Perinatal Medicine
- Endocrinology
- Neonatology
Background:
- Maternal and fetal glucose-insulin homeostasis is crucial during pregnancy.
- Understanding factors influencing neonatal insulin levels is important for assessing fetal well-being.
- Previous studies have explored various factors affecting cord blood insulin.
Purpose of the Study:
- To investigate the concentration and distribution of insulin in umbilical cord blood plasma.
- To examine the relationship between maternal factors (e.g., intravenous fluids, delivery route) and cord insulin levels.
- To assess the potential role of "stress" in elevated cord insulin concentrations at birth.
Main Methods:
- Analysis of 854 umbilical cord blood plasma samples and 503 maternal blood samples.
- Estimation of glucose and insulin concentrations in collected samples.
- Statistical analysis to compare insulin levels based on delivery method and maternal interventions.
Main Results:
- The mean cord insulin concentration, excluding infants of diabetic mothers, was 7 muU./ml.
- A skewed distribution was observed, with 10% of infants showing cord insulin levels of 12 muU./ml. or higher.
- Intravenous fluids during labor tended to exaggerate the skewness of insulin distribution.
- Infants born vaginally had slightly lower mean insulin values compared to those born via Caesarean section.
Conclusions:
- Neonatal insulin levels at birth exhibit a skewed distribution, with a notable percentage of infants having elevated concentrations.
- Maternal intravenous fluid administration during labor may influence cord insulin levels.
- Delivery route (vaginal vs. Caesarean section) is associated with minor differences in cord insulin.
- The findings suggest that "stress" is unlikely to be the primary factor responsible for high cord insulin values at birth.
Abstract:
The concentration of glucose and insulin was estimated in 854 samples of umbilical cord blood plasma and 503 concurrently collected maternal blood samples. The mean cord insulin concentration, excluding all infants born to known diabetic mothers, was 7 muU./ml., but the distribution was skewed with 10 per cent of infants having a value of 12 muU./ml. or more. The giving of intravenous sugar-coating fluids to the mother during labor tended to exaggerate the skewness rather than move the whole distribution to the right. Babies born by vaginal route, whatever the presentation of method of delivery, had slightly lower mean insulin values than those born by Caesarean section. It thus seems unlikely that "stress" is a factor causing high cord insulin values at birth. Other data concerning maternal-fetal glucose and insulin relations are discussed.