Cord Blood Leptin, Osteocalcin, And Tumor Necrosis Factor Alpha Levels In Gestational Diabetic Versus Normal Pregnancy: Impact On Neonatal Outcome In A Birth Cohort

Background: Although gestational diabetes may result in elevated leptin, osteocalcin, and TNF-alpha (Tumor necrosis factor) levels, impact of those parameters on the neonatal outcome is not well established.Objectives: The aim of the current study was to evaluate whether cord blood leptin, TNF alpha (Tumor necrosis factor), and osteocalcin have a predictive value for neonatal complications due to maternal GDM (Gestational Diabetes Mellitus).Methods: This cohort study was performed at Near East University Hospital, Nicosia, Cyprus. All pregnant females under follow-up of the department of Obstetrics and Gynecology between years 2 010 and 2 012 were invited to participate. Those, who gave consent, were enrolled. Expecting mothers were categorized as GDM and normal pregnancy. 41 (21.5%) of the pregnancies were GDM and 159 (78.5%) were normal. Cord blood samples were obtained at delivery. Osteocalcin, leptin, and TNF-alpha levels and neonatal complications were evaluated thereafter.Results: Comparison of pregnancy complications between groups revealed no significant differences except for more frequent maternal hypothyroidism in the GDM group (P < 0.001). The GDM group's cord blood osteocalcin levels (44.69 +/- 27.6 ng/mL and 35.23 +/- 22.9 ng/mL in the control group (P : 0.037)) and frequency of neonatal hypoglycemia were significantly higher than controls (P : 0.047), whereas cord blood TNF alpha and leptin levels were not statistically different (P > 0.05). Newborns with hypoglycemia showed higher cord blood osteocalcin, TNF-alpha, and leptin. In addition, osteocalcin levels were significantly higher in cord blood of LGA babies born from GDM mothers (50.41 +/- 32.79 and 35.19 +/- 20.18 ng/mL).Conclusions: In this study, cord blood leptin, osteocalcin, and TNF-alpha were significantly correlated with neonatal hypoglycemia. Moreover, cord blood osteocalcin levels were significantly higher in the GDM group. This increase in osteocalcin in the GDM group, may be related to the regulation of blood glucose levels by osteocalcin.