Role of Cord Blood C-peptide Levels in Early Prediction of Hypoglycemia in Infants of Diabetic Mothers

Open Access

Abstract

Background: C-peptide measurement reflects pancreatic β-cell activity and endogenous insulin secretion. In infants of diabetic mothers, hyperinsulinemia increases glucose utilization, predisposing to early neonatal hypoglycemia. Timely identification of at-risk infants is crucial to prevent hypoglycemia-related neurological morbidity. Objective: To evaluate the role of cord blood C-peptide levels in the early prediction of hypoglycemia among infants born to diabetic mothers. Methods & Materials: A comparative cross-sectional study was conducted in the Department of Obstetrics and Gynecology at Dhaka Medical College Hospital. A total of 113 infants of diabetic mothers were enrolled through purposive sampling after meeting predefined inclusion and exclusion criteria. Cord blood C-peptide was measured at birth, and neonatal glucose was monitored early. Data were analyzed using SPSS 23.0 with descriptive statistics and chi-square or appropriate non-parametric tests; p<0.05 indicated significance at 95% confidence interval. Results: A significant difference was noted between hypoglycemic and normoglycemic groups (p<0.001). Cesarean delivery was more frequent among hypoglycemic infants (92%). Hypoglycemia predominantly occurred within 12 hours (mean glucose 2.72±0.90 mmol/L), while normoglycemic infants peaked at 6 hours (4.09±1.17 mmol/L). Maternal HbA1c and cord blood C-peptide levels were significantly higher in hypoglycemic infants (p<0.001). Conclusion: Neonatal hypoglycemia is more common in infants of diabetic mothers, particularly those delivered by cesarean section. Elevated cord blood C-peptide levels are strongly associated with hypoglycemia, indicating that C-peptide can serve as an early and reliable predictor of hypoglycemia in IDMs.