Cord Blood C-peptide, Insulin, HbA1c, and Lipids Levels in Small- and Large-for-Gestational-Age Newborns
Ruo-Lin Hou, Wen-Yuan Jin, Xiao-Yang Chen, Yan Jin, Xiu-Min Wang, Jie Shao, Zheng-Yan Zhao
Department of Children’s Health Care, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China (mainland)
Med Sci Monit 2014; 20:2097-2105
Small- and large-for-gestational-age (SGA, LGA) newborns are associated with metabolic syndrome in their later life. Cord blood C-peptide, insulin, glycosylated hemoglobin (HbA1c), and lipids levels may be altered in SGA and LGA newborns; however, the results are conflicting. Therefore, this study aimed to determine the effect of cord blood markers on SGA and LGA newborns.
Material and Methods: This was a prospective cohort study and included 2873 term newborns of non-diabetic women. Among these newborns, 83 (2.9%) were SGA, 2236 (77.8%) were appropriate-for-gestational-age (AGA), and 554 (19.3%) were LGA newborns. Cord blood C-peptide, insulin, HbA1c, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were measured. The chi-square, Kruskal-Wallis, and Mann-Whitney tests were used to analyze categorical variables and continuous variables, respectively. Multinomial logistic regression analysis was used to determine the independent effect of these variables on SGA and LGA newborns.
Results: Cord serum TG level was significantly higher in the SGA group than in AGA and LGA groups (p<0.05). The LGA group had significantly higher cord serum insulin level than AGA and SGA groups (p<0.05). After adjustment for confounding variables, including maternal age, parity, pre-pregnancy body mass index (BMI), education, annual household income, pregnancy-induced hypertension (PIH), mode of delivery, and newborn sex, high TG and insulin levels remained significantly associated with SGA and LGA newborns, respectively (p<0.05).
Conclusions: High cord serum TG and insulin levels are independently associated with SGA and LGA newborns, respectively.
Keywords: Birth Weight, Adult, Fetal Blood - metabolism, Gestational Age, Hemoglobin A, Glycosylated - metabolism, Infant, Newborn, Insulin - blood, Lipids - blood, Pregnancy, Prospective Studies, young adult