Oxidative stress in infants of diabetic mothers: Role of ischemia modified albumin in relation to lipid peroxidation, antioxidant status and essential trace elements.

Background: Oxidative stress plays an important role in the pathogenesis of maternal and fetal complications of diabetic pregnancies.

Aim: To assess oxidative stress status in infants of diabetic mothers (IDMs) through measurement of ischemia modified albumin (IMA) and to examine its relation to lipid peroxidation, antioxidant status, essential trace elements, and maternal glycemic control.

Methods: This study was conducted on 100 full-term infants; 50 infants were born to diabetic mothers and another 50 age- and sex-matched healthy infants were enrolled as controls. Maternal laboratory investigations included random blood glucose (RBG) and HbA1c. Cord blood RBG, total antioxidant capacity (TAC), malondialdehyde (MDA), IMA, and trace elements (copper [Cu] and zinc [Zn]) were measured.

Results: Cord blood TAC, Cu, and Zn were significantly lower (p < 0.05 for all) while MDA and IMA levels were higher among IDMs compared with the control group (p < 0.001 for both). Maternal HbA1c was negatively correlated to TAC (r = -0.351, p = 0.013) while positively correlated to MDA (r = 0.305, p = 0.031) and IMA (r = 0.755, p < 0.001). IMA was also positively related to maternal RBG (r = 0.493, p < 0.001) while there were negative correlations between IMA and each of TAC (r = -0.491, p < 0.001) and Cu (r = -0.480, p = 0.001).

Conclusions: Oxidative stress is enhanced in IDMs as indicated by increased lipid peroxidation and IMA levels. This is accompanied by decreased antioxidant defense, reflected by decreased TAC, Cu, and Zn levels. Oxidant-antioxidant balance is related to maternal glycemic control. Proper glycemic control among diabetic mothers is mandatory to avoid oxidative stress and its potentially harmful effects on their infants.