Differences in newborn screening results among women with gestational diabetes mellitus

Date
2021
Authors
Estrella, Jane
Wiley, Veronica
Immanuel, Jincy
Simmons, David
Journal Title
Journal ISSN
Volume Title
Publisher
Sage
Abstract

Multiple studies undertaken on cord blood demonstrate analyte perturbations in infants exposed to gestational diabetes mellitus (GDM). Cord blood as a sample is influenced by maternal and placental metabolism. Newborn screening (NBS), performed after the first 24 hours of life reflects early neonatal metabolism. We compared NBS analytes between women with and without GDM with different management approaches in the Treatment of Booking of Gestational Diabetes (TOBOGM) pilot randomised controlled trial. Pregnant women with GDM risk factors were randomised to early or deferred GDM treatment following an oral glucose tolerance test (<20 weeks gestation). Women without GDM served as “decoys”. From the decoy group 11 developed GDM (screened at 26-28 weeks), were analysed separately; their results were compared with the other groups. De-identified controls were chosen from NBS results from the same analytic run matched for sex, birthweight and gestational age. Results were available for 73/78 women participating in the pilot and 358 de-identified controls. Tyrosine levels (μmol/l; whole blood)were higher in the late GDM group vs early, deferred treatment, and decoy groups (medians:106.28; IQR: 96.73-151.11) (76.33; 64.64-97.90) (75.68; 66.59-110.88)(73.74; 58.32-90.36) (p=0.009) and remained elevated when compared to normal, age-matched controls (106.28; 96.73-151.11) (87.26; 68.55-111.26) (p value=0.01) Immunoreactive trypsinogen (μgm/l; whole blood)was highest in the early treatment group when compared with group-specific controls (22.30; 13.90–29.90 vs 14.00, 10.60–21.10) (p=0.02). These results provide evidence of biochemical perturbations detectable on NBS of in-utero exposure to hyperglycemia and treatment and provide data for hypothesis building.

Description
Article originally published in Journal of Inborn Errors of Metabolism and Screening, 9, e20200013. English. Published online 2021. https://doi.org/10.1590/2326-4594-jiems-2020-0013
Keywords
Gestational diabetes mellitus, Diabetes in pregnancy, Newborn screening, Tyrosine, Immunoreactive trypsinogen, IRT
Citation
This is the published version of an article that is available at: https://doi.org/10.1590/2326-4594-jiems-2020-0013. Recommended citation: Estrella, J., Wiley, V., Immanuel, J., & Simmons, D. (2021). Differences in newborn screening results among women with gestational diabetes mellitus. Journal of Inborn Errors of Metabolism and Screening, 9, e20200013. This item has been deposited in accordance with publisher copyright and licensing terms and with the author’s permission.
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