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Increased plasma pro-B-type natriuretic peptide in infants of women with type 1 diabetes

Karen G Halse1, Marie L S Lindegaard, Jens P Goetze

  • 1Department of Clinical Biochemistry, University of Copenhagen, Denmark.

Clinical Chemistry
|September 24, 2005
PubMed

Insights

Maternal type 1 diabetes, especially with poor glycemic control (HbA1c ≥6.2%), elevates fetal proBNP levels. This suggests maternal diabetes impacts fetal heart function, particularly during perinatal stress.

Area of Science:

  • Neonatal cardiology
  • Endocrinology
  • Perinatal medicine

Background:

  • Maternal type 1 diabetes is linked to neonatal cardiomyopathy in up to 40% of infants.
  • Elevated B-type natriuretic peptide (BNP) and its precursor (proBNP) indicate cardiac dysfunction and hypoxia in adults.

Purpose of the Study:

  • To investigate elevated plasma proBNP and BNP concentrations in infants born to mothers with type 1 diabetes.
  • To assess the relationship between maternal glycemic control and fetal cardiac markers.

Main Methods:

  • Radioimmunoassays (RIAs) were used to measure plasma BNP and proBNP levels.
  • The proBNP assay detected intact proBNP and its fragments, while the BNP assay measured BNP-32.

Main Results:

  • Infants of mothers with type 1 diabetes and HbA1c ≥6.2% showed significantly higher median plasma proBNP (31 pmol/L) compared to controls (16 pmol/L).
  • Infants of mothers with HbA1c <6.2% had intermediate proBNP values.
  • Plasma BNP and proBNP concentrations were strongly correlated (r²=0.80, P<0.0001) and linked to fetal stress during labor in the diabetic group.

Conclusions:

  • Maternal diabetes and suboptimal metabolic control can adversely affect fetal cardiac function.
  • Increased proBNP secretion in neonates is associated with maternal diabetes and perinatal stress.
Abstract

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