Inflammatory Factors In Maternal And Umbilical Cord Blood And Adverse Pregnancy Outcomes In GDM Pregnant Women At Delivery

Objective: This study analyzed the levels of CRP,C-P,INS,MCP-1,GAL and slit-2 in maternal and umbilical cord blood,and explored the correlation between maternal and umbilical cord blood serum above factors and neonatal weight,neonatal blood sugar,and the correlation between maternal BMI and CRP,C-P,INS,MCP-1,GAL,slit-2 levels,as well as the influence of maternal BMI on neonatal weight.To provide basis for better monitoring,diagnosis and treatment of GDM in the future.Methods:According to the requirements,21 GDM pregnant women and 23 normal pregnant women who were examined and delivered regularly in our hospital from 2017 to2018 were selected.The GDM group was set as observation group,while the normal pregnant women group was set as control group.The maternal venous blood before delivery and umbilical cord venous blood after delivery were collected respectively.The serum CRP,C-P,INS,MCP-1,GAL and slit-2 were detected by ELISA.The birth weight,blood sugar at birth,Apgar score of the newborn and BMI of the prenatal mother were also measured.The following analyses were made:(1)The levels of CRP,C-P,INS,MCP-1,GAL and slit-2 in maternal and umbilical cord blood of the observation group and the control group were compared;(2)The levels of CRP,C-P,INS,MCP-1,GAL and slit-2 in maternal and umbilical cord blood of the observation group were compared;(3)The levels of CRP,C-P,INS,MCP-1,GAL and slit-2 in maternal and umbilical cord blood of the control group were compared;(4)The levels of maternal and umbilical cord blood of the observation group were compared.The correlation of CRP,C-P,INS,MCP-1,GAL and slit-2 in blood.(5)To compare the correlation between CRP,C-P,INS,MCP-1,GAL,slit-2 levels in maternal and umbilical cord blood and neonatal weight.(6)To compare the correlation between CRP,C-P,INS,MCP-1,GAL,slit-2 levels in maternal and umbilical cord blood and neonatal blood sugar.(7)To compare the correlation between maternal BMI and CRP,C-P,INS,MCP-1,GAL and slit-2 levels in maternal and umbilical cord blood.(8)To compare the relationship between maternal BMI and neonatal weight.Results:(1)The levels of C-P,Mcp-1,INS,CRP and Slight-2 in the maternal blood of the observation group were higher than those of the control group(P were 0.030,< 0.001,<0.001,< 0.001,0.003 respectively).There was no difference in GAL between the observation group and the control group(P=0.226).(2)The levels of INS and CRP in umbilical cord blood of the observation group were higher than those of the control group(P=0.009,P=0.017).There was no difference in other variables between the observation group and the control group.(3)Compared with umbilical cord blood,the levels of C-P,Mcp-1,CRP and Slight-2 in umbilical cord blood were lower than those in maternal blood(P < 0.01),and the levels of GAL were higher than those in maternal blood(P =0.042),while the levels of INS in umbilical cord blood tended to be higher than that in maternal blood,but there was no statistical difference(P = 0.477).In the control group,C-P,Mcp-1,CRP and Slight-2 in cord blood were lower than those in maternal blood(P< 0.05),while GAL and INS in cord blood and maternal blood had no statistical significance.(4)In the maternal blood of the observation group,C-P was positively correlated with INS,Slit-2 and CRP,with correlation coefficients of 0.857,0.557 and0.892(P < 0.01);INS was positively correlated with CRP,with correlation coefficient of0.766(P < 0.001);Slit-2 was positively correlated with CRP,with correlation coefficient of 0.439(P = 0.047).In the observation group,C-P was positively correlated with INS and CRP,with correlation coefficients of 0.581 and 0.750(P=0.007,P<0.001);Mcp-1was positively correlated with INS,Slit-2 and CRP,with correlation coefficients of 0.581,0.854 and 0.484(P=0.007,P<0.001,P=0.031);INS was positively correlated with Slit-2and CRP,with correlation coefficients of 0.684 and 0.459(P=0.001,P=0.042);The correlation coefficient was 0.663(P=0.001).(5)Compared with the control group,the maternal blood C-P,INS,Slit-2 and CRP of the observation group were positively correlated with neonatal weight,with correlation coefficients of 0.782,0.610,0.491 and0.635(P<0.001,P=0.004,P=0.028,P=0.003),and the umbilical cord blood C-P,INS and CRP of the observation group were positively correlated with neonatal weight,with correlation coefficients of 0.715,0.677 and 0.478(P=0.001,P=0.001,P=0.038).(6)Compared with the control group,INS in umbilical cord blood was negatively correlated with neonatal blood sugar in the observation group,with a correlation coefficient of-0.673(P=0.012),while no correlation was observed for other variables.(7)Compared with the control group,the maternal blood C-P,INS,Slit-2 and CRP in the observation group were positively correlated with the maternal BMI,with correlation coefficients of0.895,0.741,0.496 and 0.887(P<0.001,P<0.001,P=0.026,P<0.001),and the umbilical cord blood C-P,INS and CRP in the observation group were positively correlated with the maternal BMI,with correlation coefficients of 0.874,0.487 and 0.588(P<0.001,P=0.034,P=0.008).(8)In the observation group,BMI was positively correlated with neonatal weight,the correlation coefficient was 0.784,P < 0.001.Conclusions: 1.There are microinflammation and insulin resistance in maternal circulating blood of GDM patients.2.Slit-2 level in circulating blood may be related to the occurrence and development of GDM;Slit-2 level in umbilical cord blood may be related to hyperinsulinemia and microinflammation in GDM newborns.3.The gestational environment of GDM causes fetal hyperinsulinemia,which is closely related to neonatal hypoglycemia.4 The macrosomia of pregnancy may be related to the microinflammation and insulin resistance of the mother and fetus.