Transplacental Passage of Islet Cell Antibody in Infants of Diabetic Mothers

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Abstract
Summary: The incidence of pancreatic islet cell antibody (ICAb) was assessed in the cord blood and sera of infants of diabetic mothers (IDM). ICAb activity was detected in the cord blood of 10 of 36 (27.8%) consecutive IDM studied and in 0 of 111 (0%) cord bloods of normal control infants. In all instances, ICAb activity in the cord sera was of the immunoglobulin (IgG) class and was associated with ICAb in maternal sera at the time of delivery. No correlation was observed between the incidence of ICAb in IDM and alterations in fetal growth parameters, congenital malformation rates, cord blood insulin levels, or the incidence of neonatal complications. The evidence would support transplacental passage of ICAb from diabetic mothers to their offspring, but would not support a primary pathogenetic role for ICAb in the clinical or metabolic alterations observed in these infants. Speculation: The detection of ICAb in the cord blood of IDM at birth would suggest a possible role for transplacentally-acquired ICAb in the pathogenesis of the clinical, metabolic, and morphologic abnormalities observed in these infants.

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