Relationship of Glucose, C-peptide, Leptin, and BDNF in Maternal and Umbilical Vein Blood in Type-1 Diabetes.

The study aimed to determine the relationship between glucose, C-peptide, brain-derived neurotrophic factor (BDNF), and leptin between mother and fetus and neonatal weight. METHODS: In the prospective observational cohort study, we included 66 women with type-1 diabetes mellitus (T1DM). According to the z-score for neonatal weight, patients were divided into healthy-weight neonates (n = 42) and overweight neonates (n = 24). The maternal blood samples were taken during pregnancy and cesarean section when the umbilical vein blood sample was also withdrawn. The maternal vein sera were analyzed for fasting glucose, C-reactive protein (CRP), leptin, BDNF, TSH, FT3, and FT4. The umbilical vein sera were analyzed for glucose, C-peptide, leptin, TSH, thyroid-stimulating protein (FT3), free thyroxine (FT4), and BDNF concentration. The neonatologist measured the skinfold thickness on the third day of neonatal life. RESULTS: A strong correlation was confirmed between maternal and umbilical vein glucose concentration and maternal glucose and C-peptide in umbilical vein blood. A negative correlation was found between the concentration of BDNF in the umbilical vein and glucose in maternal blood. A strong correlation was seen between BMI and maternal blood leptin concentration, neonatal fat body mass, and umbilical vein blood leptin concentration. Higher BMI elevated BDNF, and TSH increase the odds for overweight neonates in the first trimester of pregnancy. Maternal higher leptin concentration in the first trimester decrease the odds of overweight neonates. CONCLUSIONS: Maternal glucose concentrations affect the fetus's glucose, C-peptide, and BDNF concentrations. Leptin levels increase in maternal blood due to increased body mass index, and in the neonate, fat body mass is responsible for increased leptin concentrations.

Can neonatal myasthenia gravis be predicted?

AIM: To determine any association between history of mothers with myasthenia gravis (MG) and the occurrence of neonatal myasthenia gravis (NMG). METHODS: The prospective study involved pregnant women with MG and their newborns delivered in our center throughout the nine-year period. The study included 16 newborns with NMG and 33 healthy newborns without symptoms of NMG. Their outcome was evaluated in relation to the duration of the illness (<5, 5-10, >10 years) and maternal therapy (no therapy, mestinon, corticosteroid, or combination of the two). RESULTS: The duration of maternal illness and type of therapy were not predictive of neonatal outcomes (P=0.159, and P=0.578, respectively). CONCLUSION: The duration of illness and therapy of women with MG do not correlate with manifestation of NMG and do not predict which pregnancies would result in an affected child. Because of possible severe, unpredictable, and life threatening NMG, these births should be carried out in a tertiary birth center.