The association between a single abnormal glucose and fetal c-peptide

Area of Science:

• Perinatal medicine
• Endocrinology
• Obstetrics

Background:

• Gestational diabetes mellitus (GDM) screening involves glucose tolerance tests (GTT).
• The impact of mild glucose intolerance on fetal physiology is not fully understood.
• Fetal C-peptide levels reflect fetal insulin production.

Purpose of the Study:

• To determine if fetuses of mothers with one elevated GTT value exhibit different C-peptide levels compared to those with normal GTT results.
• To investigate the physiological differences in fetal insulin secretion based on maternal glucose tolerance.

Main Methods:

• Prospective cohort study comparing singleton, non-anomalous fetuses.
• Fetal C-peptide levels measured in cord blood.
• Data analyzed using univariable analysis after log transformation and outlier exclusion.

Main Results:

• Fetal C-peptide levels were significantly higher in the group with one elevated GTT value (4.6 ± 0.8 pmol/L) versus the normal GTT group (4.3 ± 0.7 pmol/L, P=0.046).
• No significant differences were observed in maternal characteristics or adverse perinatal outcomes between the groups.

Conclusions:

• Fetuses of mothers with one elevated GTT value demonstrate a measurable physiological difference in C-peptide levels.
• This suggests that even mild maternal glucose intolerance may influence fetal endocrine function.