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Published on: April 3, 2017
Umbilical cord blood concentration of connecting peptide (C-peptide) and pregnancy outcomes
Atrin Niknam1, Fahimeh Ramezani Tehrani2, Samira Behboudi-Gandevani3
1Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Umbilical cord blood C-peptide levels are linked to gestational diabetes mellitus (GDM) and neonatal macrosomia. This finding may aid in stratifying risks for newborns of mothers with GDM or overweight conditions.
Area of Science:
- Perinatology
- Neonatal Health
- Endocrinology
Background:
- C-peptide is a potential marker for childhood metabolic outcomes.
- Umbilical cord blood C-peptide may aid in risk stratification for neonates born to mothers with diabetes or overweight conditions.
- The clinical significance of C-peptide in this context requires further investigation.
Purpose of the Study:
- To investigate the associations between fetomaternal metabolic variables and umbilical cord blood C-peptide concentration.
- To explore the relationship between gestational diabetes mellitus (GDM), macrosomia, and C-peptide levels.
- To assess the utility of C-peptide as a biomarker in neonatal metabolic health.
Main Methods:
- A cohort of 858 pregnant women from a larger GDM screening trial was analyzed.
- Umbilical cord (UC) blood C-peptide concentrations were measured.
- Pregnancy outcomes including macrosomia/large for gestational age (LGA) and cesarean section (CS) were assessed, with median regression used for analysis.
Main Results:
- Gestational diabetes mellitus (GDM) status was positively associated with increased UC blood C-peptide concentration.
- Increased birth weight was significantly correlated with higher UC blood C-peptide levels.
- In multivariate analysis, GDM and macrosomia were independently associated with elevated UC blood C-peptide, even after adjusting for maternal factors.
Conclusions:
- UC blood C-peptide concentration is significantly associated with maternal GDM and neonatal macrosomia.
- Further research stratifying by maternal BMI and gestational weight gain, and exploring markers like Leptin and IGF-1, is warranted.
- These findings contribute to understanding metabolic disturbances during pregnancy and their impact on neonatal C-peptide levels.
Background:
C-peptide offers potential as a marker to indicate childhood metabolic outcomes. Measuring C-peptide concentration might have better future utility in the risk stratification of neonates born to overweight or diabetic mothers. Prior research has tried to bring this matter into the light; however, the clinical significance of these associations is still far from reach. Here we sought to investigate the associations between fetomaternal metabolic variables and umbilical cord blood C-peptide concentration.
Methods:
For the present study, 858 pregnant women were randomly selected from among a sub-group of 35,430 Iranian pregnant women who participated in a randomized community non-inferiority trial of gestational diabetes mellitus (GDM) screening. Their umbilical cord (UC) blood C-peptide concentrations were measured, and the pregnancy variables of macrosomia/large for gestational age (LGA) and primary cesarean section (CS) delivery were assessed. The variation of C-peptide concentrations among GDM and macrosomia status was plotted. Due to the skewed distribution of C-peptide concentration in the sample, median regression analysis was used to identify potential factors related to UC C-peptide concentration.
Results:
In the univariate model, positive GDM status was associated with a 0.3 (95% CI: 0.06 - 0.54, p = 0.01) increase in the median coefficient of UC blood C-peptide concentration. Moreover, one unit (kg) increase in the birth weight was associated with a 0.25 (95% CI: 0.03 - 0.47, p = 0.03) increase in the median coefficient of UC blood C-peptide concentration. In the multivariate model, after adjusting for maternal age, maternal BMI, and macrosomia status, the positive status of GDM and macrosomia were significantly associated with an increase in the median coefficient of UC blood C-peptide concentration (Coef.= 0.27, 95% CI: 0.13 - 0.42, p < 0.001; and Coef.= 0.34, 95% CI: 0.06 - 0.63, p = 0.02, respectively).
Conclusion:
UC blood concentration of C-peptide is significantly associated with the incidence of maternal GDM and neonatal macrosomia. Using stratification for maternal BMI and gestational weight gain (GWG) and investigating molecular markers like Leptin and IGF-1 in the future might lay the ground to better understand the link between metabolic disturbances of pregnancy and UC blood C-peptide concentration.
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