Troponin T and NT ProBNP levels in infants of gestational, TYPE1 and TYPE2 diabetic mothers and macrosomic infants

Aim: This study compares NT proBNP and troponin T levels in umblical cord arterial blood drawn during the delivery and postnatal echocardiographic findings between infants of gestational and pregestational diabetic mothers and macrosomic infants. Material and Method: Twentyseven infants of pregestational diabetic mother, 61 infants of gestational diabetic mother, 37 macrosomic infants of nondiabetic mother and 58 healthy infants of mothers without any pregestational or gestational disorders as the control group who was born between September 2011 and September 2012 after 34 weeks of gestational age were prospectively enrolled.To the study umblical cord blood was drawn during delivery to perform NT ProBNP ve Troponin T tests. Echocardiography was performed 24- 72 hours after the delivery. M mode, two dimensional, Doppler and pulse tissue Doppler echocardiography technics were used. Results: Umblical cord troponin T and NT proBNP levels were found to be higher in diabetic and macrosomic groups than the control group (all of them p< 0.001). Both pregestational and gestational diabetic mothers were divided into two group according to HbA1c level in third trimester as good (< 6.1%) and suboptimal (> 6.1%) metabolic controlled. In good and suboptimal metabolic controlled diabetic group, NT ProBNP levels were positively correlated with interventricular septum thickness (r=0.536 and r=0.576 respectively, p<0.01). Also NT ProBNP levels were positively correlated with interventricular septum/ left ventricular free wall ratio in good and suboptimal metabolic controlled diabetic groups (r=0.545 and r=0.563 respectively, p<0.01). In suboptimal metabolic controlled diabetic group, NT ProBNP was found to be positively correlated with left ventricular mass index (r=0.586 p<0.01). There was not any correlation between troponin T levels and echocardiographic findings in all the groups (p>0.05). While there was not any correlation related to myocardial performance index between infants of diabetic mothers and control group, myocardial performance index of macrosomic infants was lower than the control group (p=0,017). Conclusion: NT proBNP levels correlation with septal hypertrophy in suboptimal metabolic controlled infants of diabetic mothers shown in this study make an emphasize the importance of the control of diabetes mellitus during pregnancy.