Increased N-terminal pro-brain type natriuretic peptide secretion in infants of diabetic mothers

Abstract

Background: Diabetes is recognized as a particular threat to pregnant women and their neonates. B-type natriuretic peptide (BNP) and N-terminal-proBNP play an important role in the regulation of extracellular fluid volume and blood pressure. BNP inhibits myocardial fibrosis and hypertrophy. Aim: To test the hypothesis that cord blood NT-proBNP would be increased in infants of diabetic mothers (IDMs) and linking its concentration to the degree of maternal glycemic control. Subjects and methods: This case control study was conducted on 85 full term neonates born at the Obstetrics and Gynecology department at Ain-Shams University Hospitals. The studied neonates were classified into 3 groups; Group I (n = 30) included IDMs with good maternal glycemic control (HbA_1c <6%), group II (n = 25) included IDMs with suboptimal maternal glycemic control (HbA_1c ≥6%) and healthy control group (n = 30). The included mothers/infants dyads were subjected to detailed history taking, thorough clinical examination and laboratory investigations which included maternal HbA_1c and cord blood NT-proBNP. Results: Cord blood NT-proBNP levels were higher in IDMs with suboptimal maternal glycemic control than those born to healthy mothers, while NT-proBNP levels were comparable between neonates with good maternal glycemic control and healthy controls. NT-proBNP levels were higher in IDMs with suboptimal maternal glycemic control than those born to mothers with good glycemic control. NT-proBNP showed significant correlations with maternal HbA_1c and one minute Apgar score. Conclusions: Neonatal NT-BNP concentrations are related to maternal glycemic control and perinatal hypoxia. In infants born to mothers with suboptimally controlled diabetes, NT-proBNP increases.