The Diabetic Pregnancy: A Study of Serum Lipids in Maternal and Umbilical Cord Blood and of the Uterine and Placental Vasculature

Abstract

It has been shown that even with good diabetic control foetal loss in diabetic pregnancy exceeds the standard (Farquhar, 1959; Hagbard, 1961; Oakley, 1961). There is now evidence that in the non-diabetic an increase in the low-density serum lipoproteins plays a part in the causation of degenerative vascular disease (Gofman, Jones, Lindgren, Lyon, Elliott and Strisower, 1950; Kannel, Dawber, Kagan, Revotskie and Stokes, 1961). It has also been shown that in diabetes there is a tendency for these low-density lipoproteins to be increased, particularly in the untreated or poorly controlled patient (Albrink and Man, 1958; Wolff and Salt, 1958; Salt, Wolff, Nestadt and Lloyd, 1960), but it is not clear whether this lipidaemia is important in the causation of the vascular complications of diabetes. In normal pregnancy a considerable rise of low-density lipoproteins occurs and reaches its peak during the last trimester (Oliver and Boyd, 1955; Studnitz, 1955; Watson, 1957; Smith, de Alvarez and Forsander, 1959; de Alvarez, Gaiser, Simkins, Smith and Bratvold, 1959). We present a study designed to show whether: (1) in diabetic pregnancy this rise in serum lipoproteins is more marked and or occurs at an earlier stage of pregnancy; (2) the lipids in umbilical cord blood of infants of diabetic mothers differ from those of infants of non-diabetic mothers; and (3) a correlation exists between increased concentrations of lipoproteins on the one hand, and the state of the blood vessels in the rectus muscle, uterus, and placenta, and the outcome of pregnancy on the other.