Document Detail


Hyperglycemia and adverse pregnancy outcome study: neonatal glycemia.
MedLine Citation:
PMID:  21078733     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The goal was to describe the temporal pattern of neonatal plasma glucose levels and associations with maternal glucose levels, cord serum C-peptide levels, and neonatal size and adiposity.
METHODS: A total of 17,094 mothers and infants were included in the Hyperglycemia and Adverse Pregnancy Outcome Study (15 centers in 9 countries). Mothers underwent a 75-g, 2-hour, oral glucose tolerance test (OGTT) at 24 to 32 weeks of gestation. Cord blood and neonatal blood samples were collected. Biochemical neonatal hypoglycemia was defined as glucose levels of <10th percentile (2.2 mmol/L). Clinically identified hypoglycemia was ascertained through medical record review and associations were assessed.
RESULTS: Plasma glucose concentrations were stable during the first 5 hours after birth. Maternal glucose levels were weakly positively associated with biochemical neonatal hypoglycemia (odds ratios: 1.07-1.14 for 1-SD higher OGTT glucose levels). Frequency of neonatal hypoglycemia was higher with higher cord C-peptide levels (odds ratio: 11.6 for highest versus lowest C-peptide category). Larger and/or fatter infants were more likely to have hypoglycemia (P < .001), and infants with hypoglycemia tended to have a higher frequency of cord C-peptide levels of >90th percentile.
CONCLUSIONS: Mean neonatal plasma glucose concentrations varied little in the first 5 hours after birth, which suggests normal postnatal adjustment. Biochemical and clinical hypoglycemia were weakly related to maternal OGTT glucose measurements but were strongly associated with elevated cord serum C-peptide levels. Larger and/or fatter infants were more likely to develop hypoglycemia and hyperinsulinemia. These relationships suggest physiologic relationships between maternal glycemia and fetal insulin production.
Authors:
Boyd E Metzger; Bengt Persson; Lynn P Lowe; Alan R Dyer; J Kennedy Cruickshank; Chaicharn Deerochanawong; Henry L Halliday; Anselm J Hennis; Helen Liley; Pak C Ng; Donald R Coustan; David R Hadden; Moshe Hod; Jeremy J N Oats; Elisabeth R Trimble;
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-11-15
Journal Detail:
Title:  Pediatrics     Volume:  126     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-02     Completed Date:  2011-02-08     Revised Date:  2011-06-22    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1545-52     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA. bem@northwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Glucose / metabolism*
C-Peptide / blood*
Female
Glucose Tolerance Test
Humans
Hyperglycemia / blood,  complications*
Hypoglycemia / blood,  etiology
Infant, Newborn
Infant, Newborn, Diseases / blood,  etiology*
Insulin / blood*
Pregnancy
Pregnancy Complications / blood*
Pregnancy Outcome
Risk Factors
Grant Support
ID/Acronym/Agency:
M01-RR00048/RR/NCRR NIH HHS; M01-RR00080/RR/NCRR NIH HHS; R01-HD34242/HD/NICHD NIH HHS; R01-HD34243/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/C-Peptide; 11061-68-0/Insulin
Investigator
Investigator/Affiliation:
M Contreras / ; D A Sacks / ; W Watson / ; S L Dooley / ; M Foderaro / ; C Niznik / ; J Bjaloncik / ; P M Catalano / ; L Dierker / ; S Fox / ; L Gullion / ; C Johnson / ; C A Lindsay / ; H Makovos / ; F Saker / ; M W Carpenter / ; J Hunt / ; M H Somers / ; K S Amankwah / ; P C Chan / ; B Gherson / ; E Herer / ; B Kapur / ; A Kenshole / ; G Lawrence / ; K Matheson / ; L Mayes / ; K McLean / ; H Owen / ; C Cave / ; G Fenty / ; E Gibson / ; A Hennis / ; G McIntyre / ; Y E Rotchell / ; C Spooner / ; H A R Thomas / ; J Gluck / ; D R Hadden / ; H Halliday / ; J Irwin / ; O Kearney / ; J McAnee / ; D R McCance / ; M Mousavi / ; A I Traub / ; J K Cruickshank / ; N Derbyshire / ; J Dry / ; A C Holt / ; A Khan / ; F Khan / ; C Lambert / ; M Maresh / ; F Prichard / ; C Townson / ; T W van Haeften / ; A M R van de Hengel / ; G H A Visser / ; A Zwart / ; U Chaovarindr / ; U Chotigeat / ; C Deerochanawong / ; I Panyasiri / ; P Sanguanpong / ; D Amichay / ; A Golan / ; K Marks / ; M Mazor / ; J Ronen / ; A Wiznitzer / ; R Chen / ; D Harel / ; N Hoter / ; N Melamed / ; J Pardo / ; M Witshner / ; Y Yogev / ; F Bowling / ; D Cowley / ; P Devenish-Meares / ; H G Liley / ; A McArdle / ; H D McIntyre / ; B Morrison / ; A Peacock / ; A Tremellen / ; D Tudehope / ; K Y Chan / ; N Y Chan / ; L W Ip / ; S L Kong / ; Y L Lee / ; C Y Li / ; K F Ng / ; P C Ng / ; M S Rogers / ; K W Wang / ; M Edgar / ; W Giles / ; A Gill / ; R Glover / ; J Lowe / ; F Mackenzie / ; K Siech / ; J Verma / ; A Wright / ; Y H Cao / ; J J Chee / ; A Koh / ; E Tan / ; V J Rajadurai / ; H Y Wee / ; G S H Yeo / ; D Coustan / ; B Haydon / ; A Alexander / ; D R Hadden / ; O Attias-Raved / ; M Hod / ; J J N Oats / ; A F Parry / ; A Collard / ; A S Frank / ; L P Lowe / ; B E Metzger / ; A Thomas / ; T Case / ; P Cholod / ; A R Dyer / ; L Engelman / ; M Xiao / ; L Yang / ; C I Burgess / ; T R J Lappin / ; G S Nesbitt / ; B Sheridan / ; M Smye / ; E R Trimble / ; D Coustan / ; A R Dyer / ; D R Hadden / ; M Hod / ; B E Metzger / ; L P Lowe / ; J J N Oats / ; B Persson / ; E R Trimble / ; G R Cutter / ; S G Gabbe / ; J W Hare / ; L E Wagenknecht / ; Y Chen / ; J Claman / ; J King /

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