Poster session II Clinical obstetrics, diabetes, labor, medical-surgical-disease, physiology/endocrinology, prematurity: Abstracts 237 - 386| Volume 208, ISSUE 1, SUPPLEMENT , S119-S120, January 01, 2013

261: Cord serum C peptide levels in large-for-gestational age infants in diabetic and non-diabetic mothers


      It is hypothesized that diabetic macrosomia is different from non-diabetic macrosomia in terms of fetal metabolic conditions. However, there are few useful clinical markers to distinguish diabetic and non-diabetic macrosomia. The aim of the study was to determine whether cord serum C peptide (CPR) is a useful marker in term large-for-gestational age (LGA) infants.

      Study Design

      In this prospective study, we measured cord serum CPR concentration in singletone term LGA infants of diabetic and non-diabetic mothers. We included both pregestational diabetes and gestational diabetes (GDM) in the diabetic group. We used the Japanese birthweight standard curve to define LGA infants. We compared cord CPR levels between the diabetic and the nondiabetic groups. We also tested the difference between the groups after adjusting for confounding variables including prepregnancy body mass index (BMI), gestational age (GA) at delivery, and birthweight standard deviation (BWSD).


      We included 97 LGA infants, in which 25 and 72 infants were born from diabetic and non-diabetic mothers, respectively. Cord CPR levels were significantly higher in the diabetic infants than in the non-diabetic infants (p< .01) (Table). The higher CPR levels were, the more likely infants were diabetic, with an adjusted odds ratio (OR) of 2.73 per 1 ng/ml (95% confidence interval [CI], 1.37-5.44). If CPR>2.0 ng/ml, adjusted OR for diabetic macrosomia was 7.06 (95% CI, 2.02-24.67).
      Tabled 1Cord serum CPR levels in diabetic and non-diabetic infants
      Table thumbnail grr22


      Our findings suggest that, in term singleton LGA infants, cord serum CPR is a useful marker of diabetic macrosomia, being distinguishable from non-diabetic macrosomia.