Umbilical Cord C-Peptide Level and Its Relationship to Common Early Complications in Infants of Diabetic Mothers

Abstract

Background: Diabetes during pregnancy is associated with increased maternal, fetal, and neonatal morbidity and mortality. Infants of diabetic mothers (IDM) frequently develop complications related to fetal hyperglycemia and hyperinsulinemia. Cord blood C-peptide is a reliable indicator of fetal beta-cell function due to its longer half-life and lower susceptibility to hemolysis compared with insulin. Objectives: To study the relationship between umbilical cord C-peptide levels and common early complications in infants of diabetic mothers. Materials and Methods: This cross-sectional study included 45 neonates of diabetic mothers admitted to the neonatal care unit in cooperation with the Department of Obstetrics and Gynecology, Babil Teaching Hospital, over nine months from 1 November 2022 to 31 July 2023. Cord blood C-peptide levels were measured, and serial blood glucose, serum calcium, hematocrit, and total serum bilirubin (TSB) were monitored. All neonates underwent echocardiography, abdominal and brain ultrasonography. Maternal and neonatal data were recorded. Results: Among 45 neonates, no significant differences were observed in maternal characteristics, including age and parity. Cord blood C-peptide levels were significantly higher in neonates with macrosomia (3.88 ± 1.11 nmol/L, p < 0.001), hypoglycemia at 1 hour (3.51 ± 1.17 nmol/L, p < 0.001), respiratory distress syndrome (RDS) (3.37 ± 1.22 nmol/L, p = 0.005), and hyperbilirubinemia (p < 0.001) compared with neonates without these complications. Conclusion: Elevated cord blood C-peptide levels are associated with early complications such as hypoglycemia, hyperbilirubinemia, and respiratory distress in IDMs, suggesting its potential as an early predictive marker.