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http://purl.uniprot.org/citations/15502930http://www.w3.org/1999/02/22-rdf-syntax-ns#typehttp://purl.uniprot.org/core/Journal_Citation
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Aims/hypothesis

In this study we investigated whether chronic fetal hypoxia, as indicated by amniotic fluid erythropoietin levels, is associated with perinatal morbidity in type 1 diabetic pregnancies.

Methods

A total of 331 women with type 1 diabetes had at least one childbirth between 1995 and 2000. The amniotic fluid erythropoietin concentration was measured in 156 diabetic singleton pregnancies at a median time of 1 day before Caesarean section without labour contractions and in 19 healthy control subjects at Caesarean section.

Results

The median amniotic fluid erythropoietin level was 14.0 mU/ml (range 2.0-1975.0) in diabetic pregnancies and 6.3 mU/ml (range 1.7-13.7) in controls (p<0.0001). Of the 156 diabetic patients, 21 (13.5%) had amniotic fluid erythropoietin levels higher than 63.0 mU/ml. Amniotic fluid erythropoietin levels correlated negatively with umbilical artery pH (r=-0.49, p<0.0001) and pO2 (r=-0.62, p<0.0001) at birth and neonatal lowest blood glucose level (r=-0.47, p<0.0001). Positive correlations were found between amniotic fluid erythropoietin levels and umbilical artery pCO2 (r=0.49, p<0.0001) and last maternal HbA1c (r=0.43, p<0.0001). Furthermore, a U-shaped correlation was demonstrated between amniotic fluid erythropoietin levels and birthweight z score (z score below -0.6 SD units: r=-0.63, p=0.0007; z score above +1.0 SD units: r=0.32, p=0.0014). Neonatal hypoglycaemia, hypertrophic cardiomyopathy and admission to the neonatal intensive care unit occurred significantly more often in cases with high amniotic fluid erythropoietin levels (>63.0 mU/ml) than in those with normal levels. Multivariate logistic regression analysis revealed that amniotic fluid erythropoietin was the only variable independently related to low umbilical artery pH (<7.21; p<0.0001) and neonatal hypoglycaemia (p=0.002). Low umbilical artery pO2 (<15.0 mm Hg) was explained by amniotic fluid erythropoietin (p<0.0001) and birthweight z score (p=0.004).

Conclusions/interpretation

Antenatal high amniotic fluid erythropoietin levels can identify type 1 diabetic pregnancies at increased risk of severe perinatal complications."xsd:string
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http://purl.uniprot.org/citations/15502930http://purl.uniprot.org/core/author"Eronen M."xsd:string
http://purl.uniprot.org/citations/15502930http://purl.uniprot.org/core/author"Markkanen H."xsd:string
http://purl.uniprot.org/citations/15502930http://purl.uniprot.org/core/author"Teramo K."xsd:string
http://purl.uniprot.org/citations/15502930http://purl.uniprot.org/core/author"Hiilesmaa V."xsd:string
http://purl.uniprot.org/citations/15502930http://purl.uniprot.org/core/author"Kari M.A."xsd:string
http://purl.uniprot.org/citations/15502930http://purl.uniprot.org/core/date"2004"xsd:gYear
http://purl.uniprot.org/citations/15502930http://purl.uniprot.org/core/name"Diabetologia"xsd:string
http://purl.uniprot.org/citations/15502930http://purl.uniprot.org/core/pages"1695-1703"xsd:string
http://purl.uniprot.org/citations/15502930http://purl.uniprot.org/core/title"High amniotic fluid erythropoietin levels are associated with an increased frequency of fetal and neonatal morbidity in type 1 diabetic pregnancies."xsd:string
http://purl.uniprot.org/citations/15502930http://purl.uniprot.org/core/volume"47"xsd:string
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