Related Experiment Videos
Decreased platelet counts in infants of diabetic mothers
D W Green1, F Mimouni, J Khoury
1University of Cincinnati, Children's Hospital Medical Center, Department of Pediatrics, Ohio, USA.
Insights
Infants of diabetic mothers (IDMs) show higher red blood cell production and lower platelet counts. This suggests a link between erythropoiesis and thrombopoiesis in these infants.
Area of Science:
- Neonatal Hematology
- Endocrinology
- Developmental Biology
Background:
- Infants of diabetic mothers (IDMs) often exhibit signs of increased fetal red blood cell production (erythropoiesis).
- This is thought to be a response to chronic low oxygen levels in the womb (intrauterine hypoxemia).
- The relationship between increased erythropoiesis and platelet production (thrombopoiesis) in IDMs is not fully understood.
Purpose of the Study:
- To investigate the association between increased erythropoiesis and thrombopoiesis in neonates.
- To determine if these hematologic changes in infants of diabetic mothers correlate with maternal blood sugar control during pregnancy.
Main Methods:
- Compared absolute nucleated red blood cell counts and platelet counts in the first 24 hours of life.
- Studied 32 term, non-asphyxiated IDMs and 47 healthy control infants.
- Analyzed correlations between neonatal hematologic parameters and maternal glycemic control data.
Main Results:
- IDMs had significantly higher nucleated red blood cell counts compared to controls.
- IDMs also presented with significantly lower platelet counts than controls.
- A significant inverse correlation was observed between nucleated red blood cell counts and platelet counts in neonates.
- No correlation was found between these neonatal hematologic findings and maternal glycemic control parameters.
Conclusions:
- Increased erythropoiesis in infants of diabetic mothers is accompanied by decreased platelet counts.
- Findings support the hypothesis of erythropoietin-driven stem cell differentiation favoring red blood cell production over platelet production.
- These hematologic alterations in IDMs may be independent of maternal glycemic control during pregnancy.
Abstract:
Infants of diabetic mothers (IDMs) have hematologic indices consistent with increased fetal erythropoiesis, presumably in response to chronic intrauterine hypoxemia. We hypothesized that increased erythropoiesis, as is evident from increased nucleated erythrocyte counts, would be accompanied by interrelated changes in thrombopoiesis and would correlate with maternal glycemic control during pregnancy. We compared absolute nucleated erythrocyte counts and platelet counts obtained in the first 24 hours of life in 32 term, nonasphyxiated IDMs with 47 controls. The IDM group had higher absolute nucleated erythrocyte counts (1.0 +/- 1.3 x 10(9)/L versus 0.4 +/- 0.7 x 10(9)/L; p < 0.05), and lower platelet counts (235 +/- 77 x 10(9)/L versus 348 +/- 79 x 10(9)/L; p < 0.001) than controls. Absolute nucleated erythrocyte counts correlated inversely with platelet counts (r = -0.28; p < 0.02). These neonatal hematologic measurements did not correlate with various parameters of maternal glycemic control. We conclude that in IDMs, increased erythropoiesis is accompanied by decreased platelet counts. These data are consistent with the theory of an erythropoietin-induced shift of fetal multipotent stem cell differentiation toward erythropoiesis at the expense of thrombopoiesis.