Fetomaternal adrenomedullin levels in diabetic pregnancy

We investigated whether maternal and fetoplacental adrenomedullin, a newly discovered hypotensive peptide involved in the insulin regulatory system, i s modified in diabetic pregnancy. We studied its correlation with pregnancy complications associated with this disease. Thirty-six pregnant women with diabetes (13 with type I and 23 with gestational diabetes mellitus) and in 40 uncomplicated pregnancies were included. 10 out of 36 diabetic pregnanc ies were complicated by gestational hypertension. In each woman, adrenomedu llin concentration in maternal and fetal plasma and in amniotic fluid was a ssessed by specific radioimmunoassay. We found that overall mean amniotic f luid adrenomedullin concentration was higher (p <0.05) in diabetic (14.7 +/ -1.6 fmol/ml) than in uncomplicated pregnancies (10.8 +/-0.9 fmol/ml), wher eas no differences were present in maternal and fetal plasma adrenomedullin levels between diabetic and uncomplicated pregnant women. High levels of a mniotic fluid adrenomedullin were found in both type I and gestational diab etes mellitus pregnancies (13.7 +/-1.4 and 15.6 +/-2.2 fmol/ml, respectivel y). Diabetic pregnancies complicated by gestational hypertension showed low er (p <0.05) amniotic fluid adrenomedullin concentrations than normotensive diabetic patients. These findings suggest that placental adrenomedullin pr oduction is upregulated in diabetic pregnancy, and it may be important to p revent excessive vasoconstriction of placental vessels.