{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:47:54Z","timestamp":1782362874168,"version":"3.54.5"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the effects of maternal glycemic control during pregnancy on early biomarkers of neonatal metabolic syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We prospectively enrolled 130 pregnant women. Based on glycemic control, they were classified into adequate control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200982, including 59 with normal glucose tolerance and 23 with well-controlled GDM) and poor control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200948, GDM with suboptimal control). Neonatal tyrosine, alanine, total carnitine, C18 acylcarnitine, bilirubin, and hypoglycemia incidence were measured. Multivariable linear regression adjusted for confounders, with Bonferroni correction (\n                      <jats:italic>\u03b1<\/jats:italic>\n                      =0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with the adequate glycemic control group, neonates in the poor glycemic control group exhibited significantly lower levels of tyrosine and alanine (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05), and significantly higher levels of total carnitine, C18 acylcarnitine, and bilirubin (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). The incidence of neonatal hypoglycemia was also significantly higher (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). There were no significant differences between groups in the exact timing of blood sampling for amino acids or bilirubin (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). After adjustment for pre-pregnancy body mass index (BMI), gestational age at delivery, mode of delivery, neonatal sex, maternal age, parity, feeding before blood collection, and thyroid dysfunction, poor maternal glycemic control remained independently associated with decreased neonatal tyrosine (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u2212\u22120.335,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.009) and alanine (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.289,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.019), as well as increased total carnitine (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.381,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003), C18 acylcarnitine (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.348,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.006), and bilirubin levels (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.405,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002). After Bonferroni correction for multiple comparisons (\n                      <jats:italic>\u03b1<\/jats:italic>\n                      \u2009=\u20090.01), tyrosine, total carnitine, C18 acylcarnitine, and bilirubin remained statistically significant, while alanine did not.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Poor glycemic control during pregnancy is associated with multiple abnormalities in early neonatal metabolic biomarkers during the first 72\u2005h after birth. Optimizing glycemic control during pregnancy may help mitigate early metabolic disturbances in the neonatal period. Future long-term follow-up studies are needed to determine whether these early biomarkers predict subsequent metabolic syndrome in later childhood or adulthood.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1874461","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:21:29Z","timestamp":1782361289000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of maternal glycemic control during pregnancy on early biomarkers of neonatal metabolic syndrome"],"prefix":"10.3389","volume":"14","author":[{"given":"Xiaogang","family":"An","sequence":"first","affiliation":[{"name":"Pediatric Department, Shanxi Province Fenyang Hospital","place":["Fenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajun","family":"Kong","sequence":"additional","affiliation":[{"name":"Obstetrics Department, Shanxi Province Fenyang Hospital","place":["Fenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1415069","DOI":"10.3389\/fcdhc.2024.1415069","article-title":"The prevalence of gestational diabetes among underweight and normal weight women worldwide: a scoping review","volume":"5","author":"Gitlin","year":"2024","journal-title":"Front Clin Diabetes Healthc"},{"key":"B2","doi-asserted-by":"publisher","first-page":"440","DOI":"10.3390\/life15030440","article-title":"The hidden impact of gestational diabetes: unveiling offspring complications and long-term effects","volume":"15","author":"Al Bekai","year":"2025","journal-title":"Life (Basel)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e79555","DOI":"10.7759\/cureus.79555","article-title":"Long-term cardiovascular and metabolic health outcomes of gestational diabetes Mellitus: a systematic review","volume":"17","author":"Ullah","year":"2025","journal-title":"Cureus"},{"key":"B4","doi-asserted-by":"publisher","first-page":"255","DOI":"10.2337\/dbi24-0014","article-title":"Stopping the intergenerational risk of diabetes-from mechanisms to interventions: a report on research supported by pathway to stop diabetes","volume":"74","author":"Harnois-Leblanc","year":"2025","journal-title":"Diabetes"},{"key":"B5","doi-asserted-by":"publisher","first-page":"3388","DOI":"10.3390\/nu15153388","article-title":"Research progress of maternal metabolism on cardiac development and function in offspring","volume":"15","author":"Ren","year":"2023","journal-title":"Nutrients"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1020","DOI":"10.1111\/1753-0407.13460","article-title":"The link between obesity and insulin resistance among children: effects of key metabolites","volume":"15","author":"Yan","year":"2023","journal-title":"J Diabetes"},{"key":"B7","doi-asserted-by":"publisher","first-page":"E183","DOI":"10.1152\/ajpendo.00368.2023","article-title":"Intramuscular diacylglycerol accumulates with acute hyperinsulinemia in insulin-resistant phenotypes","volume":"327","author":"McKenna","year":"2024","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1276","DOI":"10.1038\/s41390-025-04432-z","article-title":"Bilirubin: translational perspectives","volume":"99","author":"V\u00edtek","year":"2026","journal-title":"Pediatr Res"},{"key":"B9","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1001\/jama.2024.21972","article-title":"World medical association declaration of Helsinki: ethical principles for medical research involving human participants","volume":"333","year":"2025","journal-title":"JAMA"},{"key":"B10","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1515\/jpem-2023-0513","article-title":"Newborn screening for primary carnitine deficiency using a second-tier genetic test","volume":"37","author":"Lin","year":"2024","journal-title":"J Pediatr Endocrinol Metab"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1512499","DOI":"10.3389\/fendo.2025.1512499","article-title":"Comparison between 75-g and 100-g oral glucose tolerance tests using international association of diabetes and pregnancy study group one-step diagnostic threshold to detect gestational diabetes mellitus","volume":"16","author":"Zhou","year":"2025","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B12","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1159\/000514711","article-title":"Neonatal hypoglycaemia: a never-ending story?","volume":"118","author":"Vain","year":"2021","journal-title":"Neonatology"},{"key":"B13","doi-asserted-by":"publisher","first-page":"469","DOI":"10.5603\/gpl.102641","article-title":"Effects of gestational diabetes mellitus with different birth weight on genetic metabolism of newborns. A retrospective cohort study","volume":"96","author":"Xia","year":"2025","journal-title":"Ginekol Pol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2128","DOI":"10.2337\/dc23-2489","article-title":"Neonatal amino acids and acylcarnitines associated with maternal blood glucose levels throughout pregnancy: insights from the Beijing birth cohort study","volume":"47","author":"Zheng","year":"2024","journal-title":"Diabetes Care"},{"key":"B15","doi-asserted-by":"publisher","first-page":"7037","DOI":"10.3390\/ijms25137037","article-title":"Origin and roles of alanine and glutamine in gluconeogenesis in the liver, kidneys, and small intestine under physiological and pathological conditions","volume":"25","author":"Hole\u010dek","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1016\/j.cmet.2023.03.016","article-title":"Pyruvate-supported flux through medium-chain ketothiolase promotes mitochondrial lipid tolerance in cardiac and skeletal muscles","volume":"35","author":"Koves","year":"2023","journal-title":"Cell Metab"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e23478","DOI":"10.1096\/fj.202302163R","article-title":"Tracer-based lipidomics enables the discovery of disease-specific candidate biomarkers in mitochondrial \u03b2-oxidation disorders","volume":"38","author":"Schwantje","year":"2024","journal-title":"FASEB J"},{"key":"B18","doi-asserted-by":"publisher","first-page":"2101","DOI":"10.1007\/s00125-023-05989-2","article-title":"Metabolomic insights into maternal and neonatal complications in pregnancies affected by type 1 diabetes","volume":"66","author":"Meek","year":"2023","journal-title":"Diabetologia"},{"key":"B19","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.jhep.2023.02.010","article-title":"Ketohexokinase-C regulates global protein acetylation to decrease carnitine palmitoyltransferase 1a-mediated fatty acid oxidation","volume":"79","author":"Helsley","year":"2023","journal-title":"J Hepatol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"2012","DOI":"10.21037\/tp-24-356","article-title":"Maternal glycemic profiles during pregnancy and predelivery correlate with neonatal glucose homeostasis and jaundice risk: a prospective cohort study","volume":"13","author":"Zhang","year":"2024","journal-title":"Transl Pediatr"},{"key":"B21","doi-asserted-by":"publisher","first-page":"170","DOI":"10.3390\/antiox12010170","article-title":"Bilirubin levels are negatively correlated with adiposity in obese men and women, and its catabolized product, urobilin, is positively associated with insulin resistance","volume":"12","author":"Kipp","year":"2023","journal-title":"Antioxidants (Basel)"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e1787","DOI":"10.1210\/clinem\/dgae267","article-title":"Approach to the neonate with hypoglycemia","volume":"109","author":"Lord","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"key":"B23","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1186\/s43042-024-00615-1","article-title":"Alterations in the metabolic signature of full-term infants of diabetic mothers","volume":"25","author":"Awad","year":"2024","journal-title":"Egypt J Med Hum Genet"},{"key":"B24","doi-asserted-by":"publisher","first-page":"6933","DOI":"10.2147\/ijgm.S537139","article-title":"Construction and evaluation of a prediction model for neonatal hyperbilirubinemia","volume":"18","author":"Xu","year":"2025","journal-title":"Int J Gen Med"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1874461\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:21:30Z","timestamp":1782361290000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1874461\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":24,"alternative-id":["10.3389\/fped.2026.1874461"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1874461","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]},"article-number":"1874461"}}