Cord blood levels of insulin and glucose in full-term pregnancies.

OBJECTIVES

This pilot study was undertaken to know the normal values of cord blood insulin and glucose levels in full-term normal pregnancies and pregnancies complicated with maternal conditions like pregnancy induced hypertension (PIH), thyroid dysfunction and Gestational Diabetes Mellitus (GDM).

METHOD

Full-term pregnancies from Ketkar maternity hospital, Nagpur, since January 2011 were included in the study. A total of 121 cases have been studied. Demographic and clinical data of the included cases was obtained from the hospital records. Cord blood sample was analyzed for serum insulin and plasma glucose levels. These two metabolic parameters were used to derive (Homeostatic Model Assessment) HOMA index for insulin resistance and Glucose-to-Insulin Ratio (GIR). The data on physical and metabolic parameters was analyzed using parametric statistical significance tests for means and correlation using R-package

RESULT

The difference in glucose concentration was found insignificant (p > 0.05) across complicated and uncomplicated pregnancies. However, for the comparison 'no complications' vs PIH, the insulin levels differed significantly at 10% (p = 0.09). Accordingly, for the same comparison, GIR also indicated significant difference at 10% (p = 0.07) between the two maternal groups. The mean cord blood glucose level was higher in PIH cases compared to un-complicated maternal cases; while the mean insulin level was lower in PIH cases as compared to non-complicated cases, as a result mean GIR was higher in PIH category. HOMA did not show significant difference in any comparison. The relationship of metabolic parameters and the derived variables with birth weight in the two maternal groups showed insignificant relationships between birth weight and dependent variables (p > 0.05).

CONCLUSION

The levels of insulin and glucose in normal full-term pregnancies was found to be 6.75 +/- 2.96 mIU/ ml and 91.69 +/- 27.05 mg/dl respectively with GIR of 13.57 +/- 7.47 and HOMA 1.57 +/- 0.83. Low serum insulin levels with normal or high GIR was noted in pregnancies complicated by PIH. Insulin resistance as measured by HOMA IR is increased in patients with hypothyroidism. Hyperinsulinemia is seen in babies with birth weight less than 2.5 kg or more than 3.5 kg.