Metabolic parameters and fetal development in offspring of mothers with gestational diabetes

Abstract

Introduction: Increasing incidence of GDM and LGA births predispose children for obesity related diseases, metabolic syndrome and type 2 Diabetes. Aims: The aim of the study was to investigate the cause of enhanced fetal growth (>90 centiles)in well controlled gestational diabetic pregnancies. Subjects and methods: 37 GDM mothers and 46 healthy control subjects and their newborns participated in the cross sectional study. Blood samples were taken from mother before delivery and from neonates at the time of delivery and tested for concentration of adiponectin, leptin, insulin, c peptide, cholesterol, triglycerides, HDL and LDL cholesterol. Results: Gestational diabetic mothers had significantly higher BMI (first trimester) than a control group (29.6 ±6.0 vs. 23.3 ± 4.3, P<0.0001) and adiponectin concentration were significantly lower in gestational diabetic mothers compared with healthy control subjects (10871.3 ± 5184.2 vs. 13418.9 ± 5148.6, P=0.021). In offspring of GDM concentration of adiponectin (24469.0 ± 10478.8 vs. 45359.6 ± 7592, P=0.0017) is significantly lower in LGA newborns of GDM mothers compared with LGA newborns of healthy control; and concentration of Insulin is significantly higher in AGA (11.3 ±14.1 vs.4.3 ±3.2, P<0.0001) and LGA (12.9 ±6.4 vs. 5.8 ±2.9, P=0.035) newborn of GDM mothers compared with AGA and LGA newborns of healthy control. Conclusions: The findings of this study describe an altered metabolic environment for the fetus even in well controlled GDM mothers. Hyperinsulinemia and hypoadiponectinemia in macrosomic infants are predisposing factors that can contribute in development of obesity related disorder later in their life