title: Differential expression of cord blood neurotrophins in gestational diabetes: the impact of fetal growth abnormalities.
abstract: OBJECTIVE
  Gestational diabetes mellitus (GDM) may induce fetal macrosomia or growth restriction and is associated with later offspring neurodevelopmental disorders. We aimed to determine whether neurotrophins brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF) and neurotrophin-4 (NT-4) are differentially expressed in cord blood samples at birth in large-for-gestational-age (LGA), intrauterine-growth-restricted (IUGR) and appropriate-for-gestational-age (AGA) offspring of diabetic mothers, as compared to AGA controls from non-diabetic mothers.
  
  
  METHODS
  BDNF, NGF and NT-4 concentrations were prospectively determined in 80 cord blood samples from LGA (n = 15), IUGR (n = 12) and AGA (n = 33) diabetic, as well as from AGA normal (controls, n = 20) singleton full-term pregnancies.
  
  
  RESULTS
  Fetal BDNF concentrations considerably decreased in GDM, as compared with normal pregnancies [(b = -2.836, 95%CI -5.067 to (-0.604), p = 0.013)] and were higher in females (b = 2.298, 95%CI 0.357-4.238, p = 0.021). Cord blood NGF concentrations were lower in IUGR than AGA infants (p = 0.038).
  
  
  CONCLUSIONS
  BDNF is down-regulated in the fetus exposed to GDM, independently of the fetal growth pattern, probably representing a candidate mechanism underlying the association between maternal diabetes and later psychopathology. IUGR fetuses born to diabetic mothers present with NGF deficiency, which may contribute to their long-term neurodevelopmental sequelae. Gender-dependent differences in fetal BDNF may partly explain the higher prevalence of adverse neurodevelopmental outcomes following brain insults in male infants.
authors.affiliation: a Department of Neonatology , National and Kapodistrian University of Athens , Athens , Greece.
authors.forename: Despina D
authors.initials: DD
authors.lastname: Briana
authors.affiliation: a Department of Neonatology , National and Kapodistrian University of Athens , Athens , Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Papastavrou
authors.affiliation: a Department of Neonatology , National and Kapodistrian University of Athens , Athens , Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Boutsikou
authors.affiliation: b Laboratory of Clinical Biochemistry-Molecular Diagnostics, 2nd Department of Pediatrics , National and Kapodistrian University of Athens , Athens , Greece.
authors.forename: Antonios
authors.initials: A
authors.lastname: Marmarinos
authors.affiliation: b Laboratory of Clinical Biochemistry-Molecular Diagnostics, 2nd Department of Pediatrics , National and Kapodistrian University of Athens , Athens , Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Gourgiotis
authors.affiliation: a Department of Neonatology , National and Kapodistrian University of Athens , Athens , Greece.
authors.forename: Ariadne
authors.initials: A
authors.lastname: Malamitsi-Puchner
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D005317:Fetal Growth Retardation / Q000097:blood*; D005320:Fetal Macrosomia / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009414:Nerve Growth Factors / Q000097:blood*; D011247:Pregnancy
chemical_list: D009414:Nerve Growth Factors
keywords: Gestational diabetes mellitus; fetal macrosomia; intrauterine growth restriction; neurotrophins; pregnancy