406 A CTS Team Approach to Identifying Risk of Neonatal Hypoglycemia and its Relationship with Endothelial Dysfunction
OBJECTIVES/GOALS: Neonatal hypoglycemia is seen in 65% of maternally diabetic pregnancies, and can lead to severe neurological damage. Neonatal glycemia may also be an indicator of placental function in these pregnancies. The purpose of this study is to identify patterns of neonatal glycemia, and as...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2024-04-01
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| Series: | Journal of Clinical and Translational Science |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2059866124003522/type/journal_article |
| _version_ | 1797226945419673600 |
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| author | Aditya Devidas Mahadevan Jennifer Pruitt Leslie A. Parker Helen Jones |
| author_facet | Aditya Devidas Mahadevan Jennifer Pruitt Leslie A. Parker Helen Jones |
| author_sort | Aditya Devidas Mahadevan |
| collection | DOAJ |
| description | OBJECTIVES/GOALS: Neonatal hypoglycemia is seen in 65% of maternally diabetic pregnancies, and can lead to severe neurological damage. Neonatal glycemia may also be an indicator of placental function in these pregnancies. The purpose of this study is to identify patterns of neonatal glycemia, and associated endothelial dysfunction, by maternal diabetes subtype. METHODS/STUDY POPULATION: Pregnancies with maternal Type 1 (T1DM), Type 2 (T2DM), and gestational diabetes mellitus (GDM) are being enrolled. Maternal hemoglobin A1c (HbA1c) and umbilical cord insulin/glucose are being collected from 20 pregnancies in each group, 10 of which also undergo placental/umbilical cord tissue collection. Following delivery, neonatal blood glucose levels are also collected every 3-4 hours (4+ measurements) to determine rate of glycemic change. Linear regression modeling will be used to determine associations with placental and umbilical endothelial RNA expression, umbilical cord insulin levels, and maternal HbA1c within each diabetic subtype and between normoglycemic and hypoglycemic neonates. Endothelial gene expression will be compared using paired t-tests with Benjamini-Hochberg correction. RESULTS/ANTICIPATED RESULTS: Thus far, 5 T1DM, 10 T2DM, and 13 GDM samples have been collected. Gestational age at delivery and birth weight were similar between groups (38.1 ± 1.05 weeks; 3.6 ± 0.59 kilograms) and delivery method is evenly distributed (Cesarean section or vaginal delivery). Currently, with limited cohort size, no association is evident between maternal HbA1c and umbilical cord glucose/insulin (p=0.114) or neonatal hypoglycemia diagnosis (p=0.674) when controlled for gestational age and infant birthweight. We hypothesize that, with pending analyses, maternal HbA1c and umbilical cord insulin levels will correlate negatively with the rate of neonatal glycemic change, and positively with the level of inflammatory and angiogenic transcription identified in placental and umbilical endothelium. DISCUSSION/SIGNIFICANCE: Characterization of postnatal glucose control is key to prognosis and risk stratification of infants of diabetic mothers. Understanding placental response to glucose, as well as sequela in the fetal endothelium, is also critical to understanding the pathogenesis of neonatal hypoglycemia and other adverse outcomes of diabetic pregnancy. |
| first_indexed | 2024-04-24T14:32:58Z |
| format | Article |
| id | doaj.art-25ea1d933209456fa0cfb97c0a91a1bc |
| institution | Directory Open Access Journal |
| issn | 2059-8661 |
| language | English |
| last_indexed | 2024-04-24T14:32:58Z |
| publishDate | 2024-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Journal of Clinical and Translational Science |
| spelling | doaj.art-25ea1d933209456fa0cfb97c0a91a1bc2024-04-03T01:59:55ZengCambridge University PressJournal of Clinical and Translational Science2059-86612024-04-01812012110.1017/cts.2024.352406 A CTS Team Approach to Identifying Risk of Neonatal Hypoglycemia and its Relationship with Endothelial DysfunctionAditya Devidas Mahadevan0Jennifer Pruitt1Leslie A. Parker2Helen Jones3University of Florida Clinical and Translational Science InstituteUniversity of Florida Clinical and Translational Science InstituteUniversity of Florida College of NursingUniversity of Florida College of Medicine; Center for Research in Perinatal OutcomesOBJECTIVES/GOALS: Neonatal hypoglycemia is seen in 65% of maternally diabetic pregnancies, and can lead to severe neurological damage. Neonatal glycemia may also be an indicator of placental function in these pregnancies. The purpose of this study is to identify patterns of neonatal glycemia, and associated endothelial dysfunction, by maternal diabetes subtype. METHODS/STUDY POPULATION: Pregnancies with maternal Type 1 (T1DM), Type 2 (T2DM), and gestational diabetes mellitus (GDM) are being enrolled. Maternal hemoglobin A1c (HbA1c) and umbilical cord insulin/glucose are being collected from 20 pregnancies in each group, 10 of which also undergo placental/umbilical cord tissue collection. Following delivery, neonatal blood glucose levels are also collected every 3-4 hours (4+ measurements) to determine rate of glycemic change. Linear regression modeling will be used to determine associations with placental and umbilical endothelial RNA expression, umbilical cord insulin levels, and maternal HbA1c within each diabetic subtype and between normoglycemic and hypoglycemic neonates. Endothelial gene expression will be compared using paired t-tests with Benjamini-Hochberg correction. RESULTS/ANTICIPATED RESULTS: Thus far, 5 T1DM, 10 T2DM, and 13 GDM samples have been collected. Gestational age at delivery and birth weight were similar between groups (38.1 ± 1.05 weeks; 3.6 ± 0.59 kilograms) and delivery method is evenly distributed (Cesarean section or vaginal delivery). Currently, with limited cohort size, no association is evident between maternal HbA1c and umbilical cord glucose/insulin (p=0.114) or neonatal hypoglycemia diagnosis (p=0.674) when controlled for gestational age and infant birthweight. We hypothesize that, with pending analyses, maternal HbA1c and umbilical cord insulin levels will correlate negatively with the rate of neonatal glycemic change, and positively with the level of inflammatory and angiogenic transcription identified in placental and umbilical endothelium. DISCUSSION/SIGNIFICANCE: Characterization of postnatal glucose control is key to prognosis and risk stratification of infants of diabetic mothers. Understanding placental response to glucose, as well as sequela in the fetal endothelium, is also critical to understanding the pathogenesis of neonatal hypoglycemia and other adverse outcomes of diabetic pregnancy.https://www.cambridge.org/core/product/identifier/S2059866124003522/type/journal_article |
| spellingShingle | Aditya Devidas Mahadevan Jennifer Pruitt Leslie A. Parker Helen Jones 406 A CTS Team Approach to Identifying Risk of Neonatal Hypoglycemia and its Relationship with Endothelial Dysfunction Journal of Clinical and Translational Science |
| title | 406 A CTS Team Approach to Identifying Risk of Neonatal Hypoglycemia and its Relationship with Endothelial Dysfunction |
| title_full | 406 A CTS Team Approach to Identifying Risk of Neonatal Hypoglycemia and its Relationship with Endothelial Dysfunction |
| title_fullStr | 406 A CTS Team Approach to Identifying Risk of Neonatal Hypoglycemia and its Relationship with Endothelial Dysfunction |
| title_full_unstemmed | 406 A CTS Team Approach to Identifying Risk of Neonatal Hypoglycemia and its Relationship with Endothelial Dysfunction |
| title_short | 406 A CTS Team Approach to Identifying Risk of Neonatal Hypoglycemia and its Relationship with Endothelial Dysfunction |
| title_sort | 406 a cts team approach to identifying risk of neonatal hypoglycemia and its relationship with endothelial dysfunction |
| url | https://www.cambridge.org/core/product/identifier/S2059866124003522/type/journal_article |
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