Published online Sep 15, 2023. doi: 10.4239/wjd.v14.i9.1393
Peer-review started: May 6, 2023
First decision: May 19, 2023
Revised: May 24, 2023
Accepted: August 4, 2023
Article in press: August 4, 2023
Published online: September 15, 2023
Gestational diabetes mellitus (GDM) has become increasingly prevalent globally. Glycemic control in pregnant women with GDM has a critical role in neonatal complications.
To analyze the early neonatal complications in GDM, and examine the effect of blood glucose control level on neonatal infection.
The clinical data of 236 pregnant women with GDM and 240 healthy pregnant women and newborns during from March 2020 to December 2021 the same period were retrospectively analyzed, and the early complications in newborns in the two groups were compared. The patients were divided into the conforming glycemic control group (CGC group) and the non-conforming glycemic control group (NCGC group) based on whether glycemic control in the pregnant women with GDM conformed to standards. Baseline data, immune function, infection-related markers, and infection rates in neonates were compared between the two groups.
The incidence of neonatal complications in the 236 neonates in the GDM group was significantly higher than that in the control group (P < 0.05). Pregnant women with GDM in the NCGC group (n = 178) had significantly higher fasting plasma glucose, 2 h postprandial blood glucose and glycated hemoglobin A1C levels than those in the CGC group (n = 58) (P < 0.05). There were no differences in baseline data between the two groups (P > 0.05). Additionally, the NCGC group had significantly decreased peripheral blood CD3+, CD4+, CD8+ T cell ratios, CD4/CD8 ratios and immunoglobulin G in neonates compared with the CGC group (P < 0.05), while white blood cells, serum procalcitonin and C-reactive protein levels increased significantly. The neonatal infection rate was also significantly increased in the NCGC group (P < 0.05).
The risk of neonatal complications increased in pregnant women with GDM. Poor glycemic control decreased neonatal immune function, and increased the incidence of neonatal infections.
Core Tip: Gestational diabetes mellitus (GDM) is an important complication that affects pregnancy outcome. Pregnant women with GDM and long-term abnormal glucose metabolism are closely associated with the risk of adverse maternal and neonatal outcomes. Some studies suggest that the immune function of newborns may be significantly affected by GDM, and that the effect of glycemic control is related to pregnancy outcomes and neonatal prognosis. In this study, we confirmed that the risk of neonatal complications increased in pregnant women with GDM, and poor glycemic control leads to impairment of fetal immune system and ultimately increases the risk of neonatal infections.