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Prothrombotic Risk Factors in Infants of Diabetic Mothers

Journal of Perinatology volume 25, pages 134–138 (2005)Cite this article

Abstract

BACKGROUND:

Infants of diabetic mothers (IDMs) are at an increased risk for thromboembolic disease. The mechanism(s) to explain this association is unclear. We hypothesized that the pathophysiology of thrombosis in IDMs is multifactorial and likely involves interactions among genetic and acquired factors affecting the procoagulant, anticoagulant and fibrinolytic pathways.

OBJECTIVE:

To compare the prevalence of common prothrombotic risk factors in a cohort of IDMs to a matched control group.

PATIENTS/METHODS:

Full-term infants born to mothers with diet controlled (A1-IDM) (N=17), insulin requiring diabetes (ID-IDM) (N=20) and healthy term infants (controls) (N=20) matched for mode of delivery had cord blood collected at delivery. Samples were analyzed for the following: factor V Leiden (FVL), prothrombin 20210A (P20210A), methylenetetrahydrofolate reductase C677 T (MTHFR), Factor VIII (FVIII), Protein C (PC), Lipoprotein(a) (Lp(a)) and plasminogen activator inhibitor-1 (PAI-1).

RESULTS:

None of the infants had a clinically apparent thrombotic event. IDM mothers and their infants were clinically similar to controls except for a higher prevalence of hypoglycemia (30 vs 0%; p=0.005). There was no significant difference in the prevalence of the common genetic risk factors (FVL, P20210A, MTHFR) FVIII, or PAI-1 levels. Elevated Lp(a) levels were seen more frequently in IDMs than Controls (40 vs 20%) but this difference was not statistically significant. The PC activity (%) was significantly decreased in the IDM group compared to controls, 35±12 vs 44±9 (p<0.005). A1-IDM had lower PC activity compared to ID-IDM (p=0.05) and controls (p=0.001).

CONCLUSIONS:

PC deficiency is likely one mechanism to explain thrombosis in IDMs.

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Acknowledgements

We thank all the nurses in the Labor and Delivery at Hartford Hospital and midlevel practitioners in the Neonatal Intensive Care Unit at Connecticut Children's Medical Center, whose assistance was invaluable.

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Authors and Affiliations

  1. Department of Pediatrics, Divisions of Neonatology, Connecticut Children's Medical Center, Hartford, CT, USA

    Shikha Sarkar MD & Victor C Herson MD

  2. Department of Pediatrics, Division of Hematology-Oncology, Connecticut Children's Medical Center, Hartford, CT, USA

    Nathan J Hagstrom MD

  3. Department of Pediatrics, Division of Research, Connecticut Children's Medical Center, Hartford, CT, USA

    Trudy Lerer MS

  4. Department of Obstetrics and Gynecology, Hartford Hospital, Hartford, CT, USA

    Charles J Ingardia MD

  5. University of Connecticut School of Medicine, Farmington, CT, USA

    Charles J Ingardia MD

Authors
  1. Shikha Sarkar MD
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  2. Nathan J Hagstrom MD
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  3. Charles J Ingardia MD
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  4. Trudy Lerer MS
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  5. Victor C Herson MD
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Additional information

The project was supported by a fellowship research grant from the Department of Neonatology, University of Connecticut.

Presented, in part, as a poster at the Society for Pediatric Research meeting, Baltimore, MD, May, 2002.

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Sarkar, S., Hagstrom, N., Ingardia, C. et al. Prothrombotic Risk Factors in Infants of Diabetic Mothers. J Perinatol 25, 134–138 (2005). https://doi.org/10.1038/sj.jp.7211222

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