title: Copeptin and MR-proADM in umbilical cord plasma reflect perinatal stress in neonates born to mothers with diabetes and MR-proANP reflects maternal diabetes.
abstract: OBJECTIVE
  To examine concentrations of three cardiovascular propeptides in umbilical cord plasma of neonates born to mothers with Type 1, Type 2 and gestational diabetes. Measurement of cardiovascular markers in umbilical cord plasma may potentially help identify neonates at risk of postnatal complications. Neonates born to mothers with diabetes have an increased risk of neonatal morbidity and mortality, and measurement of these new biomarkers may potentially help identify neonates at risk of these complications.
  
  
  METHODS
  Copeptin, midregional proadrenomedullin (MR-proADM) and mid-regional pro-A-type natriuretic peptide (MR-proANP) were measured in cord plasma of neonates (n = 63) born to mothers with the three types of diabetes. Associations with maternal glycemic control, mode of delivery and neonatal metabolic acidosis were examined.
  
  
  RESULTS
  Umbilical cord plasma copeptin concentrations were lowest in neonates after elective cesarean sections (6.1 pmol/l; interquartile range [IQR]: 4.5-9.1) compared with emergency cesarean sections (156 pmol/l; IQR: 9.6-311; p = 0.019) and vaginal delivery (831 pmol/l; IQR: 107-2407; p < 0.0001). MR-proADM was also affected by mode of delivery; however, this seemed more likely to be caused by an inverse association with the acid-base balance. In this population, only MR-proANP plasma concentrations were related to type of diabetes. Neonates born to mothers with Type 1 diabetes had higher concentrations (median 260 pmol/l; IQR: 222-318) compared with Type 2 diabetes (175 pmol/l; IQR: 169-200; p = 0.003) and gestational diabetes (200 pmol/l; IQR: 149-276; p = 0.009).
  
  
  CONCLUSIONS
  Umbilical cord plasma copeptin and MR-proADM concentrations primarily reflect perinatal stress associated with mode of delivery and the degree of fetal acidosis, whereas MR-proANP concentrations are higher in neonates born to mothers with Type 1 diabetes.
authors: Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark.
authors: Julie
authors: J
authors: Smith
authors: Karen G
authors: KG
authors: Halse
authors: Peter
authors: P
authors: Damm
authors: Marie Ls
authors: ML
authors: Lindegaard
authors: Isis
authors: I
authors: Amer-Wåhlin
authors: Steen
authors: S
authors: Hertel
authors: Marianne
authors: M
authors: Johansen
authors: Elizabeth R
authors: ER
authors: Mathiesen
authors: Lars B
authors: LB
authors: Nielsen
authors: Jens P
authors: JP
authors: Goetze
mesh_terms: D000138:Acidosis / Q000150:complications / Q000378:metabolism / Q000473:pathology; D053607:Adrenomedullin / Q000032:analysis*; D000328:Adult; D009320:Atrial Natriuretic Factor / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D036861:Delivery, Obstetric; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000378:metabolism* / Q000473:pathology; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000473:pathology; D016640:Diabetes, Gestational / Q000378:metabolism / Q000473:pathology; D005260:Female; D005312:Fetal Blood / Q000378:metabolism*; D006020:Glycopeptides / Q000032:analysis*; D006801:Humans; D007231:Infant, Newborn; D033261:Maternal-Fetal Relations; D011247:Pregnancy; D011498:Protein Precursors / Q000032:analysis*; D013315:Stress, Psychological
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; D011498:Protein Precursors; C048197:copeptins; C088633:proadrenomedullin; D053607:Adrenomedullin; D009320:Atrial Natriuretic Factor