Cord blood FGF21 in gestational diabetes and its relationship with postnatal growth

To study whether FGF21 was present in cord blood and explore its relationship with maternal variables and postnatal growth.

The study included 157 pregnant women at the beginning of the third trimester; 79 with gestational diabetes (GDM), 78 with normal glucose tolerance (NGT), and their offspring. Glucose metabolism was assessed by oral glucose tolerance test. Insulin resistance was assessed by homeostasis model assessment index-insulin resistance (HOMA-IR). FGF21 was determined in maternal plasma drawn at recruitment and in cord blood obtained at delivery. Offspring weight and height was assessed at birth and at 12, 24 and 48 months.

Maternal FGF21 was higher in gestational diabetes than in the normal glucose-tolerant group, whereas similar cord blood FGF21 levels were observed in both groups. Lower cord blood FGF21 was strongly positively correlated with maternal circulating levels. This relationship was independent of mother's prepregnancy body mass index (BMI), glucose levels and HOMA-IR. Although maternal FGF21 levels were correlated with prepregnancy BMI and HOMA-IR index, no relationship was observed between FGF21 and birth weight. However, cord blood FGF21 levels were correlated with BMI Zeta Score at 12 and 24 months, and this relationship became stronger when only the NGT group was analyzed.

FGF21 is present in human cord blood, and its levels are closely correlated with maternal levels. The association observed between cord blood FGF21 and postnatal BMI may suggest a potential role during intrauterine life that may influence future metabolic imbalance.