Neutrophil function in neonates born to gestational diabetic mothers

To examine neutrophil functional activity in the cord blood of term neonates born to gestational diabetic mothers, in association with the type of diabetes and the development of neonatal hypoglycemia.

Neutrophil chemotaxis, random motility, and chemiluminescence was evaluated in the cord blood of 30 healthy term neonates: 12 were born to gestational diabetic mothers who received no-insulin (GDM-NI), eight to gestational diabetic mothers who received insulin (GDM), and 10 to mothers without diabetes (neonatal controls). In addition, the neutrophil functional activity in the peripheral venous blood of 10 healthy adults was analyzed.

Neutrophil functional activity in the cord blood of the neonates with and without maternal gestational diabetes was significantly lower than that in adults. As compared to neonatal controls, neonates born to both groups of GDM had decreased chemotaxis, random motility, and chemiluminescence (GDM-NI: 52.8+/-2.1 microm, p<0.001, 42.1+/-4.4 microm, p<0.001, and 140.1+/-6.9 counts per minute (cpm) x 10(3), p<0.01, respectively, and GDM: 53.0+/-1.9 microm, p<0.01, 41.8+/-4.0 microm, p<0.001, and 143.0+/-6.8 cpm x 10(3), p<0.01, respectively). Unlike controls, a tight correlation was identified between the tested neutrophil parameters in the cord blood of neonates born to diabetic mothers (r=0.70 to 0.91). The prevalence of hypoglycemia after birth was almost equal (50.0 to 41.7%) in the two groups of neonates born to diabetic mothers. There were differences in the neutrophil functional activity in the cord blood of the neonates with and without hypoglycemia.

Maternal gestational diabetes leads to impairment of cord blood neutrophil motility and postphagocytic bactericidal capacity independently from the insulin requirements for the maintenance of normoglycemia during pregnancy.