Cord blood betatrophin and insulin levels in term neonates born to mothers with gestational diabetes: A comparative cross-sectional study.

Background: Gestational diabetes mellitus (GDM) is associated with altered fetal metabolic adaptation. Betatrophin has been implicated in glucose metabolism, but its role in pregnancies complicated by GDM remains unclear. Objective: To estimate cord blood betatrophin and insulin levels and examine their relationship in term neonates born to mothers with and without GDM. Methods: This hospital-based comparative cross-sectional study was conducted over 18 months at a tertiary care maternity and neonatal hospital. Cord blood betatrophin and insulin levels were measured by ELISA in 150 term neonates born to mothers with GDM (n = 75) and normal glucose tolerance (n = 75). Biomarker levels were compared using the Mann-Whitney U test, and their association was assessed using Spearman's correlation. Univariate and multivariable linear regression analyses were performed to identify factors independently associated with betatrophin and insulin levels. Results: A total of 150 neonates (75 each in the GDM and non-GDM groups) were included. Median cord blood betatrophin levels (ng/mL) were significantly higher in neonates born to mothers with GDM than in those born to normoglycemic mothers [0.810 (IQR 0.583-1.005) vs. 0.526 (IQR 0.331-0.745) ng/mL, p < 0.001]. Similarly, median cord blood insulin levels (µIU/mL) were significantly higher in the GDM group than in the non-GDM group [12.8 (IQR 9.45-17.83) vs. 4.6 (IQR 3.66-7.10) µIU/mL, p < 0.001]. Cord blood betatrophin and insulin levels were positively correlated (r = 0.291, p < 0.001). In multivariable analysis, GDM remained independently associated with higher cord blood betatrophin (β = 0.35, 95% CI: 0.18-0.53, p = 0.045) and insulin levels (β = 10.21, 95% CI: 6.66-13.76, p < 0.001). Conclusions: Cord blood betatrophin and insulin levels were significantly elevated in neonates born to mothers with GDM. A modest but significant positive correlation between betatrophin and insulin levels suggests an association between betatrophin and fetal insulin metabolism.