Relationship between inflammatory markers, glycated hemoglobin and placental weight on fetal outcomes in women with gestational diabetes

Abstract

Objective: The aim of this study was to evaluate the relationship between inflammatory cytokines, placental weight, glycated hemoglobin and adverse perinatal outcomes (APOs) in women with gestational diabetes mellitus (GDM). Subjects and methods: This was a prospective, longitudinal and observational study conducted from April 2004 to November 2005 in Bauru, Brazil. Included patients had singleton pregnancies and performed a 100 g OGTT and had the levels of C-reactive protein (CRP), interleukin (IL)-6, TNF alfa and glycated hemoglobin (HbA1c) determined at 24-28 th gestation weeks. Results: A total of 176 patients were included, of whom 78 had the diagnosis of GDM (44.3%). Multivariate analysis demonstrated that HbA1c, age, body mass index (BMI) and previous history of GDM were independent predictors for GDM diagnosis. ROC curve indicated that HbA1C levels ≥ 5.1% at 24-28 weeks gestation were associated with GDM. No difference was found in IL-6, tumor necrosis factor alpha (TNF-alpha) and CRP serum levels in women with and without GDM. Multivariate analysis showed that placental weight was significantly associated with APOs (p < 0.005), with a cut-off value of 610 grams as demonstrated by the ROC curve. Conclusion: Placental weight ≥ 610 grams and HbA1C ≥ 5.1% were found to be associated with APOs and GDM, respectively, and their evaluation should be part of prenatal care routine.

Screening for Gestational Diabetes

“…Across the KQs reported in this manuscript, a total of 76 studies were included (18 RCTs [different screening strategies, n = 27 196; treatment benefits and harms, n = 4045], 2 nonrandomized controlled intervention studies of treatment [n = 190], and 56 observational studies [screening benefits, n = 4336; screening harms, n = 166 082; diagnostic accuracy, n = 91 260]) (Figure 2). Twenty-three studies were carried over from the prior USPSTF review and 52 new studies were added.…”

Early Identification of the Maternal, Placental and Fetal Dialog in Gestational Diabetes and Its Prevention

“…Previous studies showed an association between high levels of IL-6 and GDM [105][106][107]; however, these studies were limited by the gestational age at which IL-6 levels were measured, the population assessed, and by controlling for confounders such as BMI. Other studies failed to demonstrate a difference in IL-6 levels between GDM and normal pregnancies [108,109]. Nevertheless, a study by Hassiakos et al showed that first-trimester IL-6 levels were a significant predictor of GDM development later in pregnancy and adding IL-6 to a prediction model that included maternal characteristics yielded an improved prediction [110].…”

Role of interleukin-6 (IL-6) in predicting gestational diabetes mellitus

“…Numerous studies have been conducted on the association of IL-6 with GDM. Some studies have shown a statistically significant association between elevated IL-6 levels and GDM [ 4 , 13 , 16 ], while others did not report such relationships [ 17 , 18 ]. To this end, considering the contradictory results regarding the association between IL-6 and GDM, and based on the literature, there is no systematic review discussing the association between IL-6 and GDM.…”