F. Gloria-bottini et E. Bottini, Perinatal consequences of maternal-fetal Rh blood group interaction in diabetic pregnancy: A nonimmunological perspective, AM J MED SC, 320(1), 2000, pp. 31-35
Citations number
20
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Background: The recent discoveries about the structure of Rh protein that s
uggest a transport function and the recent observations of a positive corre
lation between Rh(D) protein and glycosylated hemoglobin levels in non-insu
lin-dependent diabetes mellitus prompted us to review our data on diabetic
pregnancy to evaluate the perinatal consequences of maternal-fetal Rh blood
group interactions in a metabolic perspective. Subjects and Methods: One h
undred thirty-two women with gestational diabetes and 120 women with preexi
sting insulin-dependent diabetes mellitus were examined. Three hundred eigh
ty-seven consecutive nondiabetic puerperae from the same population were co
nsidered control subjects. Results: In both gestational and insulin-depende
nt diabetes mellitus, an increased proportion of mother Rh(+)/newborn Rh(-)
and a decreased proportion of mother Rh(-)/newborn Rh(+) joint phenotype h
as been observed. No deviation has been observed for joint phenotypes in wh
ich mother and newborn are similar [ie, Rh(+)/Rh(+) and Rh(-)/Rh(-)]. In th
e situation of mother Rh(+)/newborn Rh(-), there is a relatively lower rate
of fetal loss and a decreased tendency to high birth weight. On the contra
ry, in pairs mother Rh(-)/newborn Rh(+) the fetus shows an increase of feta
l loss and of tendency to high birth weight. Conclusions: The results are c
ompatible with the hypothesis that when the density of Rh protein in the mo
ther is higher than that in the fetus, the conceptus is relatively protecte
d against the toxic effect of glucose. In the opposite genotypic combinatio
n (ie, density of Rh protein higher in the fetus than in the mother), the f
etus is relatively more susceptible to these effects.