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• W2996894080 abstract "The prevalence of pregestational diabetes (DM) is increasing. Clinicians often use markers of suboptimal control such as blood glucose levels and estimated fetal weight to determine timing of delivery. However, the utility of these markers is limited and stillbirth continues to be a complication of maternal DM. Cord blood N-terminal prohormone of brain natriuretic peptide (BNP) is elevated in pregnancies with poorly controlled DM. Our objective was to determine if pregnancies with DM have elevated amniotic fluid BNP as compared to pregnancies without. Given amniotic fluid is more easily accessible than cord blood prior to delivery, we sought to assess if cord blood and amniotic fluid BNP were correlated. Prospective cohort study of singleton pregnancies between 32w and 36w6d. Pregnancies with pre-existing DM were compared to pregnancies without. Fetal BNP levels were measured in amniotic fluid and cord blood. Amniotic fluid was collected at the time of rupture of membranes and cord blood was collected at delivery. These measurements were analyzed as continuous variables A total of 37 pregnancies were included for analysis, 15 with DM and 22 without. For pregnancies with DM median amniotic fluid BNP levels were significantly higher than pregnancies without (DM: 211 pg/ml [IQR 92.7-455.5, range 49-2189] vs no DM: 83.5 pg/ml [IQR 51.7-148.0, range 49-255], p =0.01). The median cord blood BNP levels were also significantly higher in pregnancies with DM as compared to pregnancies without (with DM: 1192 pg/ml [IQR 578.7-3113.5, range 367-8864] vs no DM: 586 pg/ml [IQR 325.7-1037.5, range 267-5159], p =0.01). Finally, cord blood BNP and amniotic fluid BNP levels were highly correlated (Pearson correlation coefficient 0.89). Amniotic fluid BNP is highly correlated with cord blood BNP, and both are higher in pregnancies with DM as compared to those without. Future studies should explore if amniotic fluid collected prior to delivery can be used as a marker of suboptimal maternal glucose control, adverse perinatal outcome, and to determine optimal timing of delivery." @default.
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• W2996894080 date "2020-01-01" @default.
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• W2996894080 title "1165: The DECIDE study: Evaluating biochemical markers of fetal cardiac dysfunction in diabetic and nondiabetic pregnancies" @default.
• W2996894080 doi "https://doi.org/10.1016/j.ajog.2019.11.1177" @default.
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