Correlation Analysis Of Adiponectin And Insulin In Umbilical Cord Blood Of Gestational Diabetes Maternal With The Neonatal Outcomes

Objective：1.To research the difference of adiponectin level, insulin level in umbilicalcord blood between gestational diabetes mothers and normal glucose tolerancemothers.2.To contrast and analyse the neonatal outcomes of gestational diabetes mothersand normal glucose tolerance mothers.3.To discuss the correlation between the adiponectin level and insulin level inumbilical cord blood, and the relation it with the neonatals’ outcomes of gestationaldiabetes mothers and normal glucose tolerance mothers.Methods：It was a prospective study of100cases neonatals of gestational diabetes mothersas observation group and100cases neonatals of normal glucose tolerance mothers inthe same term as control group. We collected umbilical cord blood after the neonatalsdelivered, tested the adiponectin level and insulin level in umbilical cord blood serumby Enzyme-linked immunosorbent assay, detected blood glucose values after birth30min,2hour,6hour,12hour and24hour, detected the transcutaneous bilirubin forevery neonatal everyday, detected the serum bilirubin in necessity, and recorded thecases of macrosomia, small for gestational age neonatal, neonatal hypoglycemia,hyperbilirubinemia of newborn, neonatal asphyxia, respiratory distress syndromeandand neonatal amniotic fluid inhalation syndrome, contrasted the level of adiponectinand insulin in umbilical cord blood between gestational diabetes mothers and normalglucose tolerance mothers, and contrasted the outcomes of neonatals of gestationaldiabetes mothers and normal glucose tolerance mothers, discussed the correlationbetween the adiponectin level and insulin level in umbilical cord blood, and thecorrelation between the adiponectin level or insulin level and the outcomes ofneonatals of gestational diabetes mothers and normal glucose tolerance mothers. Results：1. We contrasted the level of adiponectin and insulin of observation group andcontrol group, the difference was all statistically significant (t value of12.27and11.66respectively, P<0.05).2. The birth weight and ponderal index of the observation group were higherthan the control group, the differences were statistically significant (t value of2.764and2.725respectively, P<0.05); the incidence of macrosomia, neonatalhypoglycemia and hyperbilirubinemia of new born of observation group were higherthen control group, the differences were statistically significant (x2value of8.59,6.38and5.11respectively, P<0.05); but contrasted the body length and gestational ageof two group, the differences were not statistically significant (t value of0.087and0.977respectively, P>0.05). Although the incidence of neonatal asphyxia andneonatal amniotic fluid inhalation syndrome of observation group was higher thancontrol group, but the differences were not statistically significant (x2value of2.02and1.35respectively, P<0.05).3. There were8cases （8%）of neonatal hypoglycemia in observation group,two of them were macrosomias, making up25percent, there was no neonatalhypoglycemia in control group, the difference of the incidence rate of neonatalhypoglycemia of two groups was statistically significant(x2=6.38, P<0.05). Thedifference of the blood glucose values after birth30min of two group wasstatistically significant（t=6.402, P<0.01）.6cases of neonatal hypoglycemia inobservation group were took oral glucose, and2cases of neonatal hypoglycemia inobservation group were took glucose by vein, then, their blood glucose values werenormal, none of them had hypoglycemia symptoms.4.There were16cases （16%）of hyperbilirubinemia of newborns in observationgroup,6cases （6%） of hyperbilirubinemia of newborns in control group, wecontrasted the incidence rate of hyperbilirubinemia of newborns in tow groups, thedifference was statistically significant（x2=5.11, P<0.05）; and jaundice value of hyperbiliru-binemia of newborns in tow groups were higher with the increase of dayage. The transcutaneous bilirubin values after birth24hour,48hour,72hour,96hour,120hour and the jaundice peak value in observation group were higher than controlgroup, the difference was statistically significant (t value of2.924,6.058,4.787,3.827,5.086and5.711respectively, P<0.05).5.There was a negative correlation between the adiponectin level and insulinlevel of the observation group（r=-0.647, P<0.01）; there was a negative correlationbetween the adiponectin level and the birth weight of macrosomia（r=-0.542, P<0.05）,but the adiponectin level had no relation to the blood glucose level of neonatalhypoglycemia and the bilirubin level of hyperbilirubinemia,（r value of0.132and0.098, P>0.05）; the level of insulin had a positive relation to the birth weight ofmacrosomia（r=0.609，P<0.05）and had a negative relation to the blood glucose levelof neonatal hypoglycemia (r=-0.564, P<0.05), but had no relation to the bilirubinlevel of hyperbilirubinemia（r=0.104, P>0.05）.Conclusion：1.Gestational diabetes maternal has influence of a certain to the internalsecretion of fetus, the adiponectin level in observation group is lower than the controlgroup, and the insulin level is higher than the control group.2.Gestational diabetes maternal has different degrees influence on neonatalsoutcomes, so the incidences of macrosomia, neonatal hypoglycemia and hyperbiliru-binemia are higher, and with the pregnancy sugar screening is extensively developed,now asphyxia, respiratory distress syndrome and fetal growth restriction has beenrare.3.The neonatals delivered by gestational diabetes puerpera are easy to causehypoglycemia, especially macrosomia, so we should monitor blood glucose forroutine at30min,2h,6h,12h and24h after birth. If appear hypoglycemia shouldimmediately feed oral glucose, intravenous glucose when it is necessary 4.The neonatals delivered by gestational diabetes puerpera are easy to causehyperbilirubinemia, we should monitor jaundice dynamicly, find it early and treat itactively.5. Adiponectin level of cord blood was negatively correlated with the insulin.In observation group, adiponectin level of cord blood was negatively correlatedwith the birth weight of macrosomia, the insulin level was positively correlated withthe birth weight of macrosomia and was negatively with the blood glucose level ofhypoglycemia.