Type-1 diabetes mellitus and prenatal midtrimester screening results

OBJECTIVE: The results of studies in type-1 diabetes mellitus pregnant patients (type-1 DM) for mid-trimester distribution of serum multiple of the median (MoM) concentrations of alpha-fetoprotein (AFP), unconjugated estriol (uE3) and human chorionic gonadothropin (hCG) are often conflicting. THE AIM OF THE STUDY: This study investigated the relationship between type-1 DM and maternal serum levels of AFP, uE3, and hCG. STUDY DESIGN: The serum markers AFP, uE3 and hCG during second trimester in 25 pregnant women with uncomplicated and well controlled type-1 DM have been compared with 327 healthy controls . METHODS: Competitive radio immunochemical procedures (2nd trimester Amerlax-M, Ortho Clinical Diagnostics, USA) were used. Serum markers were expressed as MoM concentration derived from the control samples, corrected for maternal weight. Gestational age was calculated by the last menstrual period (LMP) and verified by ultrasound not later than 10 weeks after LMP. Regression functions were used for adjustment of serum levels for weight . Mann Whitney test was used to calculate the statistical significance between two studied groups. RESULTS: Mean maternal weight in controls was 68.25± 10.31 kg, and in type-1DM group 72.16± 13.12 kg (p=0.3). There were no significant differences in the distribution of hCG, AFP and uE3 between these two cohorts. All three markers AFP, uE3 and hCG levels in well controlled type-1 DM pregnant patients were lower but not statistical significant when compared to the healthy controls. All pregnancies had favourable perinatal outcome. CONCLUSIONS In centres which offer appropirate medical facilities to their type-1 DM pregnant patients and reach optimal preconceptional and during pregnancy blood glucose surveillance, general adjustment of AFP, uE3 and hCG except for weight are no longer necessary.