title: Relationship between amniotic fluid insulin and maternal blood glucose concentrations in patients with carbohydrate intolerance during pregnancy.
abstract: In contrast to maternal blood glucose, amniotic fluid insulin (AFI) directly reflects the functional state of the fetal pancreas. In a prospective study we evaluated the correlation of AFI with maternal metabolic control in 70 amniotic fluid specimens from 61 women having carbohydrate intolerance during pregnancy (White A n = 44, B0 n = 17). AFI was measured with the Insulin RIA 100 kit from Pharmacia (Freiburg). The normal range of AFI was established in 304 healthy pregnant women (16th-42nd gestational week). AFI concentrations increased by a factor of 1.5 to 2 during gestation reflecting the maturation of the fetal pancreas. Elevated AFI levels (> 97th centile) were found in 11% of normoglycemic diabetics and in 50% of women with insufficient metabolic control. Despite a high overall concordance (81%) no direct relationship could be found between fetal and maternal parameters. Patients with increased AFI values had a 5-fold higher rate of large-for-gestational age (LGA) infants than women with normal levels. This finding confirms the pathogenetic role of hyperinsulinism in the development of fetal macrosomia.
authors.affiliation: Department of Obstetrics and Gynecology, University of Cologne, Fed. Rep. of Germany.
authors.forename: G
authors.initials: G
authors.lastname: Crombach
authors.forename: C
authors.initials: C
authors.lastname: Hammerschmidt
authors.forename: B
authors.initials: B
authors.lastname: Schmitz-Röckerath
authors.forename: F
authors.initials: F
authors.lastname: Herrmann
authors.forename: M
authors.initials: M
authors.lastname: Siebolds
authors.forename: R
authors.initials: R
authors.lastname: Mies
authors.forename: A
authors.initials: A
authors.lastname: Bolte
mesh_terms: D000653:Amniotic Fluid / Q000378:metabolism*; D001786:Blood Glucose / Q000378:metabolism*; D005260:Female; D005320:Fetal Macrosomia / Q000378:metabolism; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D010179:Pancreas / Q000196:embryology / Q000378:metabolism; D011247:Pregnancy; D011446:Prospective Studies; D012016:Reference Values
chemical_list: D001786:Blood Glucose; D007328:Insulin