Objective:

To investigate the effects of maternal glycemic control during pregnancy on early biomarkers of neonatal metabolic syndrome.

Approach:

• Study Design: Prospective cohort study enrolling 130 pregnant women classified into adequate and poor glycemic control groups.
• Measurements: Neonatal levels of tyrosine, alanine, total carnitine, C18 acylcarnitine, bilirubin, and incidence of hypoglycemia were measured.
• Statistical Analysis: Multivariable linear regression adjusted for confounders, with Bonferroni correction applied.

Key Findings:

• Neonates in the poor glycemic control group had significantly lower levels of tyrosine (P < 0.05) and alanine (P < 0.05).
• Higher levels of total carnitine (P < 0.05), C18 acylcarnitine (P < 0.05), and bilirubin (P < 0.05) were observed in the poor control group.
• The incidence of neonatal hypoglycemia was significantly higher in the poor glycemic control group (P < 0.05).
• After adjustment, poor maternal glycemic control was independently associated with decreased neonatal tyrosine (β = −0.335, P = 0.009) and alanine (β = −0.289, P = 0.019), and increased total carnitine (β = 0.381, P = 0.003), C18 acylcarnitine (β = 0.348, P = 0.006), and bilirubin levels (β = 0.405, P = 0.002).

Interpretation:

Poor glycemic control during pregnancy is associated with multiple abnormalities in early neonatal metabolic biomarkers.

Limitations:

• Single-center study may limit generalizability.
• Sample size may not be sufficient to detect all potential differences.

Conclusion:

Future long-term follow-up studies are needed to determine whether these early biomarkers predict subsequent metabolic syndrome in later childhood or adulthood.