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Association between neonatal blood pressure and umbilical cord insulin concentration
1Academic Teaching Unit, Middlemore Hospital, Auckland, New Zealand.
Insights
Neonatal hyperinsulinaemia (high insulin levels at birth) may be linked to higher systolic blood pressure (SBP) in newborns. This suggests a potential early marker for metabolic syndrome risk.
Area of Science:
- Perinatal Medicine
- Endocrinology
- Metabolic Health
Background:
- The origins of metabolic syndrome are not fully understood.
- Metabolic syndrome components like elevated blood pressure and insulin levels may have prenatal origins.
Purpose of the Study:
- To investigate the relationship between neonatal blood pressure and plasma insulin concentrations at birth.
- To explore potential links between maternal health, fetal development, and neonatal metabolic parameters.
Main Methods:
- Studied neonates from diverse ethnic backgrounds, including those born to mothers with and without gestational diabetes.
- Measured umbilical cord blood insulin, C-peptide, and fructosamine.
- Assessed neonatal anthropometry and blood pressure 24 hours post-delivery.
Main Results:
- Neonates with higher systolic blood pressure (SBP) exhibited significantly higher umbilical cord insulin and C-peptide levels.
- Higher neonatal SBP was also associated with elevated neonatal and maternal fructosamine concentrations and heavier placentas.
- These findings suggest a correlation between neonatal hyperinsulinaemia and increased SBP.
Conclusions:
- Neonatal hyperinsulinaemia, potentially influenced by maternal glucose levels, may contribute to higher neonatal systolic blood pressure.
- This association could represent an early indicator of metabolic dysfunction with implications for future metabolic syndrome risk.
Abstract:
The aetiology of the metabolic syndrome remains unknown. This study investigated whether two components of this syndrome, higher blood pressure and higher plasma insulin concentrations, are related at birth. Neonates in the study were from 23 European, 25 Maori, 22 South Asian, and 25 Pacific Islands women having normal singleton pregnancies as well as 6 Maori, 5 Indian, and 19 Pacific Islands women with gestational diabetes (diagnosed by a 3 h 100 g oral glucose tolerance test at 28-32 weeks). Additional fasting glucose and fructosamine concentrations were measured at 36-38 weeks. Umbilical cord blood was taken for insulin, C-peptide, fructosamine and insulin-like growth factor I. Neonatal anthropometry and blood pressure were measured 24 h after delivery. Compared with those with a lower systolic blood pressure (SBP), neonates with a higher SBP had higher umbilical cord insulin (45.6 (39.6-52.8) vs 63.0 (54.6-72.6) pM, p < 0.01), C-peptide (0.22 (0.20-0.25) vs 0.28 (0.26-0.30) nmol l-1, p < 0.001) and fructosamine concentrations, higher maternal fructosamine concentrations and heavier placentas. These data suggest that neonatal hyperinsulinaemia, possibly driven by minor elevations in maternal glycaemia, may be linked to a higher neonatal SBP.