Maternal Inflammatory Biomarkers and Their Association with Insulin Resistance and Neonatal Outcomes Among Newborns of Women with Gestational Diabetes Mellitus

Abstract

Background: Gestational diabetes mellitus (GDM) is associated with maternal insulin resistance and low-grade inflammation and may increase the risk of adverse neonatal outcomes. This study evaluated the association of maternal inflammatory biomarkers with insulin resistance and neonatal outcomes among women with GDM.

Methods: A comparative cross-sectional study was conducted among pregnant women with GDM and normoglycemic controls. Maternal fasting glucose, fasting insulin, HOMA-IR, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and adiponectin were assessed. Neonatal birth weight, Apgar scores, macrosomia, large-for-gestational-age status, neonatal hypoglycemia, and NICU admission were recorded.

Results: In the illustrative dataset, 200 women were included, with 100 in each group. Women with GDM had higher BMI, fasting glucose, fasting insulin, and HOMA-IR than controls (all p<0.001 for the principal metabolic measures). CRP, IL-6, and TNF-α were significantly higher, whereas adiponectin was lower in GDM (all p<0.001). CRP, IL-6, and TNF-α correlated positively with HOMA-IR, while adiponectin correlated inversely. Infants of women with GDM had higher birth weight and greater frequencies of macrosomia, large-for-gestational-age status, and neonatal hypoglycemia.

Conclusion: The findings support an association between maternal inflammatory activity, insulin resistance, and adverse neonatal outcomes in GDM. Prospective studies using verified patient-level data are required to determine the predictive and clinical utility of these biomarkers.