The Influence Of Maternal Glucose Homeostasis During Pregnancy On The Early Islet Function Of Preterm Infants

Objectives1. Analysis of the influence of abnormal maternal glucose metabolism on head circumference, height, body mass index (BMI) in preterms。2. Analysis of the influence of abnormal maternal glucose metabolism during pregnancy, on premature islet function,include glucose, pro-insulin, insulin and C-peptide, and to explore the sensitivity index of islet function。3. Assessment of infants in the groups of abnormal maternal glucose metabolism about their insulin function (IR、FBCI、IAI) by blood glucose, pro-insulin, insulin and C-peptide。MethodsFrom March to December2012,82cases of premature infants in neonatal intensive care unit were divided into two groups:group of abnormal maternal glucose metabolism during pregnancy (35cases) and group of normal maternal glucose metabolism during pregnancy (47cases)。 To measure morphological indexes of infants in two groups (head circumference, body length and body weight), monitor islet function index (fasting blood glucose, pro-insulin,insulin, and C-peptide), and compare the function of islet beta-cells,including IRI, FBCI, and IAI.Results1. Compared to the normal group and abnormal group of mothers’pre-pregnancy and prenatal body mass index, the results of two groups of mother’s BMI were significant difference (P<0.05), but the result of increased weight during pregnancy between two groups was not significant difference (P>0.05)2. Comparision between the normal group and abnormal group of premature infants physical development indicators show that abnormal group of premature birth weight, head circumference and the BMI in7days after birth were higher than normal group,the difference was significance (P<0.05),but the difference between gestational age and birth length in two groups was not significant.3. Compared to the normal group and the abnormal group of premature biochemical features, the results showed that difference of pro-insulin at born and7days after birth in abnormal group was significant (P<0.05). C-peptide at7days sfter birth in two groups was significant difference (P<0.05). Otherwise, the results of the serum glucose and insulin at birth and after one week,were not significant difference (P<0.05). C-peptide in two groups at birth had no statistical significance(P>0.05).4. Compared to IR,FBCI and IAI in two groups, the results were not statistical significance (P>0.05)5. Analysis that Mother’s blood sugar during pregnancy, premature FBCI and their relevant indicators,the results showed:there was a positive correlation in mother blood sugar during pregnancy and pregnancy BMI, prenatal BMI, premature birth, insulin, c-peptide and FBCI(P<0.05), in which the mother prenatal BMI and preterm birth insulin were independent risk factors. Premature FBCI was positively correlation with mother’s blood sugar, there were no relations in mothers’ pre-pregnancy BMI and prenatal BMI. mother’s blood sugar was independent risk factor with premature FBCI.6. there was no correlation between preterm birth proinsulin and gestational age, birth weight, head circumference and length; there was no correlation between premature islet beta cell function and premature birth gestational age, weight, head circumference and length; there was no correlation between premature proinsulin and their islet beta cells function; there was no correlation between premature blood glucose and their mother pre-pregnancy BMI, prenatal BMI and mother blood glucose during pregnancy;Conclusions1. Comparion between abnormal group and normal group, premature proinsulin at birth and7days after birth was higher than normal group, showed that premature babies in abnormal group are different degree of islet beta cell function damage, indicated that premature babies will be different degree of glucose tolerance damage in the future.2. There was significantly positive correlation between mother blood sugar during pregnancy and pregnancy BMI, prenatal BMI, preterm’s insulin, c-peptide and FBCI,mother’s prenatal BMI and premature insulin are independent risk factors; indicate that mother needs to control weight to get reasonable weight gain, otherwise their glucose tolerance will be impaired and affect fetal islet cell function.3. Preterm’s FBCI and mother’s blood glucose was significantly positive, mother’s blood sugar was its independent risk factor; it indicates that mother’s blood glucose during pregnancy had affected preterm’s FBCI, therefore we must control blood sugar in reasonable range during the entire pregnancy, lest make fetal islet cell function impair early, and make abnormality occur in the future.