Amniotic fluid insulin and C-peptide as predictive markers for fetal macrosomia, birth injuries, and delivery complications?

Gestational diabetes mellitus (GDM) occurs in 3-5% of all pregnancies. GDM increases both maternal and fetal risks, causes fetal macrosomia, and hence increases the rates of caesarean sections and delivery complications such as shoulder dystocia. An early predictive marker and consequent early treat...

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Bibliographic Details
Published in:	Medical science monitor Vol. 20; pp. 54 - 58
Main Authors:	Stein, Roland Gregor, Meinusch, Malgorzata, Diessner, Joachim, Dietl, Johannes, Hönig, Arnd, Zollner, Ursula
Format:	Journal Article
Language:	English
Published:	United States International Scientific Literature, Inc 15-01-2014
Subjects:	Amniocentesis Amniotic Fluid - chemistry Biomarkers - analysis Biomarkers - metabolism Birth Injuries - diagnosis Birth Injuries - etiology Birth Injuries - metabolism Birth Weight C-Peptide - analysis Clinical Research Diabetes Complications - diagnosis Diabetes Complications - metabolism Diabetes, Gestational - diagnosis Diabetes, Gestational - metabolism Female Fetal Macrosomia - diagnosis Fetal Macrosomia - etiology Fetal Macrosomia - metabolism Humans Insulin - analysis Iodine Radioisotopes - analysis Obstetric Labor Complications - diagnosis Obstetric Labor Complications - etiology Obstetric Labor Complications - metabolism Pregnancy Retrospective Studies
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Summary:	Gestational diabetes mellitus (GDM) occurs in 3-5% of all pregnancies. GDM increases both maternal and fetal risks, causes fetal macrosomia, and hence increases the rates of caesarean sections and delivery complications such as shoulder dystocia. An early predictive marker and consequent early treatment could be beneficial, so amniotic fluid insulin and C-peptide have been examined in several studies. Increased amniotic fluid insulin in early amniocentesis between the 14th and 20th gestational week predicted a later GDM. A potential direct association with fetal macrosomia remains to be determined. This retrospective study investigated amniotic fluid insulin/C-peptide from amniocenteses between 14 and 20 weeks of gestation in correlation with fetal birth weight, type of delivery, and complications. To focus on effects of fetal hyperinsulinism apart from therapeutic confounders, we included patients who did not participate in GDM screening. Insulin and C-peptide were measured in 144 samples of frozen amniotic fluid. Birth weight, type of delivery, complications, and birth injuries were noted. Birth weights ranged from 760 g to 4410 g with a mean weight of 3424 g at an average of 40 weeks gestation. The mean amniotic fluid insulin was 4.36 U/ml and the mean C-peptide concentration was 0.076 ng/ml. There was no correlation between amniotic fluid insulin or C peptide and birth weight, type of delivery, complications, and birth injuries. Amniotic fluid insulin and C-peptide are unsuitable as predictive marker for fetal macrosomia, type of delivery, complications, or birth injuries.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Funds Collection Data Interpretation Literature Search Data Collection Study Design Manuscript Preparation Statistical Analysis
ISSN:	1643-3750 1234-1010 1643-3750
DOI:	10.12659/msm.889503