Novel predictors of preeclampsia and pregnancy complications: the impact of type 1 diabetes mellitus on maternal and fetal circulatory levels.

Pregnant women with type 1 diabetes mellitus (T1DM) are at higher risk of complication development in both mothers and their children. The present study aims to describe changes in circulating and umbilical cord concentrations of recently described predictors of pregnancy complications in a group of women with T1DM. Sixty-seven cases and 34 healthy pregnant controls were included in the study and circulatory levels of TGF-alpha, HB-EGF, BDNF, sFlt-4, PDGF, SCF, galectin-1, Fas ligand, CCL-20, P-selectin, IFNgammaR1, IL-10, IL-8, leptin, and insulin were assessed in 10 to 13, (V1), 18 to 21 (V2), 28 to 31 (V3) and 34 to 36 weeks of gestation (V4), and immediately after delivery (V5). BDNF, sFlt-4, HB-EGF, SCF, Fas ligand, galectin-1, IL-8, leptin, and insulin were higher in women with T1DM compared to controls during pregnancy (all p<0.05). While HB-EGF, CCL-20, and P-selectin correlate with maternal glucose control, circulatory SCF, P-selectin, galectin-1, PDGF, IFNgammaR1, sFlt-4, and TGF-alpha levels positively correlated with IL-10 levels suggesting that their expression is altered in the presence of inflammation. Leptin and insulin cord blood levels were higher in newborns of the mothers with T1DM relative to those without T1DM. Pregnancy of women with type 1 diabetes mellitus is associated with numerous changes in circulatory factors, but these changes are not reflected in the cord blood. The observed variations in trophic and inflammatory mediators may be linked to adverse pregnancy outcomes and could potentially be incorporated into predictive models for pregnancy complications in women with type 1 diabetes. Key words Type 1 diabetes mellitus " Serum " Plasma " Cord blood " Pregnancy complications.