Concentrations of fatty acids among macrosomic neonates delivered by healthy women and women with type 1 diabetes mellitus.

OBJECTIVE: To evaluate the concentration and profile of fatty acids (FAs) among macrosomic neonates delivered by healthy pregnant women and pregnant women with type 1 diabetes mellitus (T1DM). METHODS: A prospective study of women who delivered macrosomic neonates at a University Hospital Center, Zagreb, Croatia, 2016-2018. Maternal, umbilical vein, and arterial blood samples were collected immediately on delivery. After lipid extraction, total FAs in maternal, umbilical vein, and arterial serum samples were assessed by gas chromatography. Data were compared between women with T1DM and healthy control women. RESULTS: In total, 50 women were enrolled: 22 with T1DM and 28 control women. Neonates in the T1DM group had a higher ponderal index as compared with the control group (P=0.006). Umbilical vein insulin, insulin resistance, and leptin concentration were higher in the T1DM group than in the control group (all P<0.001). Umbilical vein serum concentrations of total saturated, monounsaturated, n-3 polyunsaturated, and n-6 polyunsaturated FAs were higher in the T1DM group (P=0.004, P<0.001, P=0.015, and P=0.014, respectively). CONCLUSION: Macrosomic neonates delivered by women with T1DM had a higher Ponderal index, and higher concentrations of insulin, leptin, and FAs in the umbilical vein and artery as compared with control group newborns.

Higher Cord Blood Levels of Fatty Acids in Pregnant Women With Type 1 Diabetes Mellitus.

Context: Type 1 diabetes mellitus (T1DM) is associated with a disturbance of carbohydrate and lipid metabolism. Objective: To determine whether T1DM alters maternal and neonatal fatty acid (FA) levels. Design: Observational study. Setting: Academic hospital. Patients: Sixty pregnant women (30 women with T1DM with good glycemic control and 30 healthy women) were included in the study. Maternal blood, umbilical vein, and artery blood samples were collected immediately upon delivery. Following lipid extraction, the FA profiles of the total FA pool of maternal serum and umbilical vein and artery serum were determined by gas chromatography. Results: Total FA concentration in maternal serum did not differ between the study groups; it was significantly higher in umbilical vein serum of the T1DM group compared with that in the control group [median (interquartile range)]: T1DM 2126.2 (1446.4 to 3181.3) and control 1073.8 (657.5 to 2226.0; P < 0.001), and in umbilical artery vein serum: T1DM 1805.7 (1393.1 to 2125.0) and control 990.0 (643.3 to 1668.0; P < 0.001). Composition of FAs in umbilical vein serum showed significantly higher concentrations of saturated, monounsaturated, and polyunsaturated FAs (SFAs, MUFAs, and PUFAs, respectively) in the T1DM group than compared with those in the control group (P = 0.001). Furthermore, cord blood levels of leptin (P < 0.001), C-peptide (P < 0.001), and insulin resistance (P = 0.015) were higher in the T1DM group compared with controls. Conclusion: The neonates born to mothers with T1DM had higher concentrations of total FAs, SFAs and MUFAs, as well as PUFAs, compared with control newborns.

Does serial 3rd trimester ultrasound improve detection of small for gestational age babies: Comparison of screening policies in 2 European maternity units.

OBJECTIVE: Methods for the antenatal detection of small for gestational age babies (SGA) differ between countries. The aim of this study was to compare the diagnostic accuracy of routine versus selective small for gestational age babies screening policy using data from two European Maternity Units. STUDY DESIGN: This was a retrospective cohort study from Liverpool Women's Hospital, UK, that uses selective third trimester sonography and from the University Hospital Centre Zagreb, Croatia, that uses routine third trimester sonography for SGA detection. Screen positive cases were defined as pregnancies with estimated fetal weight (EFW) <10th centile at the last 3rd trimester scan. True positives had both EFW and birth weight <10th centile. Pregnancy management data and perinatal outcomes were retrieved from hospital electronic data and special care baby unit (SCBU) reports. RESULTS: The proportion of small for gestational age babies was higher in Liverpool (7.8%) compared with Zagreb (4%); P<0.001. Sensitivity for detection of SGA babies in Zagreb was 27% (95%CI 15%-44%) and 33% (95%CI 23%-45%) in Liverpool. The specificity was high in both centres (Zagreb 100% (95%CI); Liverpool 98% (95%CI)). The induction of labour for antenatally diagnosed SGA babies was more common in Liverpool (38.5%) than in Zagreb (9.1%). In both centres, all antenatally diagnosed SGA babies admitted to SCBU were preterm babies. Their indications for admission to SCBU were complications related to prematurity. CONCLUSION: The effectiveness of selective SGA screening policy is comparable to universal third trimester ultrasound screening. Further prospective evaluations of SGA screening policies are warranted and they should include full cost-effectiveness analysis and assessment of possible harm from increased interventions leading to more preterm births.

Arachidonic and docosahexaenoic acid in the blood of a mother and umbilical vein in diabetic pregnant women.

OBJECTIVE: The aim of the study was to determine the total concentration of fatty acids (FAs) in the maternal vein serum and in the umbilical vein serum in pregnant women suffering from Type 1 diabetes compared to healthy women. Additional goal was to determine the percentages of arachidonic (AA) and docosahexaenoic acid (DHA) in comparison to the total concentration of FAs. METHODS: The study included 63 pregnant women, 32 suffering from Type 1 diabetes and 31 healthy pregnant women. Extraction of total lipids was performed using gas chromatography. RESULTS: There was statistically significant difference in the total FAs concentration in the maternal vein serum and the umbilical vein serum between the two groups. There was a statistically significant higher concentration of total FAs in the maternal and umbilical vein serum of the diabetic group. Higher AA and DHA concentrations were found in the maternal vein serum compared to an umbilical vein serum of the diabetic group. CONCLUSION: No difference was found in AA and DHA percentages in the maternal or in the umbilical vein serum of diabetic pregnant women. Despite of T1DM, a good metabolic control leads to insignificant changes in the AA and DHA levels in diabetic pregnancy.