THE INFLUENCE OF PRE‐ECLAMPSIA AND DIABETES MELLITUS ON PLASMA FREE AMINO ACIDS IN MATERNAL, UMBILICAL VEIN AND INFANT BLOOD

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Abstract
Summary: Plasma amino acid and total protein concentrations in the mother at delivery, in the newborn infant and in the infant at the seventh day were compared for 12 small‐for‐dates infants born to mothers with severe pre‐eclampsia and low urinary oestriol excretion, 9 large‐for‐dates infants born to mothers with diabetes mellitus and normal oestriol excretion, and 26 appropriate‐weight‐for‐dates control infants born after normal pregnancy. The latter included vaginal deliveries at and before term and deliveries by Caesarean section at term.Severe pre‐eclampsia was associated with a reduced mean maternal plasma total protein concentration and a generalized increase in plasma amino acid concentrations. Plasma total protein values in the small‐for‐dates infants at birth and at the seventh day were not significantly different from values in control infants of similar gestation period, but amino acid values at birth were usually higher than those in control infants.In diabetic mothers and their infants there were increased concentrations of aspartic acid and α‐amino‐n‐butyric acid. The concentrations of the remaining amino acids and the total plasma protein concentrations did not differ from the normal control values either in mother or infant (birth and seventh day). Ten of the twenty amino acids examined in diabetic mothers and their infants showed significant positive correlations between maternal and umbilical venous values. This degree of correlation was not found in normal or pre‐eclamptic pregnancy. Due to failure of the infant to reflect fully the higher maternal levels in toxaemia, the umbilical venous/maternal venous plasma amino acid ratios for total mean plasma amino acid concentrations and particularly for the branched‐chain amino acids valine, leucine and isoleucine were reduced.The umbilical venous plasma/maternal venous plasma ratios for normal, toxaemic and diabetic pregnancy were 1.6: 1, 1.4: 1 and 1.6: 1 respectively.In small‐for‐dates infants there was a negative correlation between amino acid concentration at birth and both birthweight and umbilical venous plasma protein concentration, suggesting a possible endogenous mobilization of amino acids in such infants.

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