Ghrelin levels in cord bloods of postpartum women with gestational diabetes mellitus and its clinical effects

Gestational Diabetes Mellitus (GDM), is one of the leading causes of maternal and fetal morbidity. It is known that lifelong probability of having type 2 diabetes mellitus is higher in affected pregnant women than the normal population. GDM is defined as a part of metabolic syndrome in some studies. Fetuses of mothers with GDM have tendency to be macrosomic and except for the brain most of the fetal organs can be affected. Fetal macrosomy and excessive somatic growth due to fetal hyperinsulinemia that is induced by maternal hyperglycemia are interrelated. Insulin, Insulin-Like Growth Factor-1 and Insulin-Like Growth Factor-2 take part in the regulation of fetal growth. There is close relation between GDM, insulin and body mass. Diabetes during pregnancy affects fetal weight. However, there may be factors other than insulin that play role in this mechanism and determination of these factors could contribute in relieving the pathophysiology. Ghrelin was first described in stomachs of rats in 1999. Ghrelin reduces fat consumption centrally and results in increase in fat tissue. At this point, it may play role in macrosomic development of fetuses of pregnant women with GDM. To date, there is no study in literature that investigates ghrelin levels in cord blood of babies delivered to mothers with GDM. For this reason we compared ghrelin levels in cord bloods of babies of 60 pregnant women with GDM and 60 healthy pregnant women as the control group. We observed an inverse correlation between weights of babies and cord blood ghrelin levels in both goups. Cord blood ghrelin levels were found to be lower in pregnant women with GDM on insulin therapy than both the control group and pregnant women with GDM that are treated by diet only. Lower cord blood ghrelin levels were observed in babies that are delivered by secerian section than those that are delivered vaginally. No relation was found between cord blood ghrelin levels and maternal age and fetal gender.As a result, inverse correlation between the weights of babies and ghrelin levels in cord bloods in both pregnant women with GDM and in control group shows us that ghrelin plays role in intrauterin fetal development. This is a preliminary and first study in the literature and it will contribute to investigations on fetal growth.