Abstract
Polycythemia is frequent in the infants of diabetic mothers (IDM). We enumerated erythroid progenitor colonies (BFU-E) and determined cord blood erythropoietin (EP) 1evels in IDM and controls. Fifteen of 18 diabetic mothers were insulin dependent and were maintained on a protocol of strict glycemic control throughout gestation. Growth of BFU-E in methylcellulose supplemented with 0.1 to 2.0 units/EP/ml followed identical dose-response curves in IDM and controls. Although numbers of BFU-E varied widely among both IDM and controls, for individual infants there was a highly significant correlation between growth at the lowest and highest doses of exogenous EP tested (r= 0.91; p < 0.0001). Mean cord blood EP values were 56 ± 21 in IDM and 44 ± 11 in controls. We observed no relationship between BFU-E growth and cord blood EP; however, cord blood pH independently correlated with both EP (r= -0.72; p= 0.006} and with the number of BFU-E observed at optimal EP (r= 0.40; p= 0.016) in IDM. The association of poor BFU-E growth with low pH and elevated EP in some infants suggested depletion of the erythroid progenitor pool in response to hypoxemia. The low incidence of elevated cord blood EP (1 of 18) in the IDM perhaps reflects a beneficial effect of strict biochemical control of maternal diabetes on fetal hypoxia. Erythroid proliferation is intrinsically normal in IDM, supporting the hypothesis that polycythemia in these infants is a secondary phenomenon.
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Shannon, K., Davis, J., Kitzmlller, J. et al. 940 ERYTHROPOIESIS IN INFANTS OF DIABETIC MOTHERS. Pediatr Res 19, 267 (1985). https://doi.org/10.1203/00006450-198504000-00970
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DOI: https://doi.org/10.1203/00006450-198504000-00970