Subclinical respiratory dysfunction in neonates born to diabetic mothers and its association with cord blood adipokines.

BACKGROUND

Maternal diabetes disrupts fetal lung development. This study aimed to compare cord blood adipokines and neonatal respiratory function tests (RFTs) in healthy neonates of diabetic mothers versus controls.

METHODS

This prospective cohort study involved term, healthy newborns born to diabetic mothers (NDM group, n = 37) and sex- and age-matched healthy controls (NHC group, n = 40). RFTs were performed at 48 h of life using tidal breath analysis (TBA). The assessed parameters included time to peak tidal expiratory flow (TPTEF), the ratio of TPTEF to total expiratory time (TPTEF/TE), the ratio of volume to peak expiratory flow to total expiratory volume (VPTEF/VE), reflecting early airway mechanics. Low respiratory function was defined as TPTEF/TE below 35%. Cord blood adipokines including leptin, ghrelin, and adiponectin levels were measured by ELISA.

RESULTS

The NDM group exhibited lower TPTEF, TPTEF/TE, and VPTEF/VE ratio TBA parameters (p < .001 for all). Cord blood leptin levels were higher in the NDM group, while ghrelin and adiponectin levels were lower (p = .002, p < .001 and p < .001 respectively). Ghrelin levels were positively correlated with TPTEF (ρ = 0.231, p = .043), TPTEF/TE (ρ = 0.264, p = .020), and VPTEF/VE (ρ = 0.236, p = .038). Decision tree analysis identified ghrelin as the primary discriminator of low RFTs, with an accuracy of 74%.

CONCLUSION

Clinically healthy term infants born to diabetic mothers exhibit measurable impairments in RFTs at birth, accompanied by altered cord blood adipokine profiles, suggesting a potential role for adipokines as early biomarkers of respiratory vulnerability.