Gestational diabetes mellitus affects the differentiation of hematopoietic stem cells in neonatal umbilical cord blood

Abstract Background and Purpose There are abundant hematopoietic stem cells (HSCs) in cord blood. It was known that HSCs continue to differentiate into common lymphoid progenitors (CLPs) and common myeloid progenitors (CMPs). Furthermore, the CMPs could differentiate into megakaryocyte erythroid progenitors (MEPs), and MEPs ultimately differentiated into platelets and erythrocytes. It had been reported that the proportion of HSCs in cord blood was higher than that in healthy pregnant women, so as the incidence of neonatal polycythemia in gestational diabetes mellitus (GDM) patients. We aimed to investigate the HSCs population and the change of their differentiation in the cord blood of neonates of GDM mothers. Methods In this study, we collected cord blood from GDM and healthy pregnant women at delivery. Totally 75 cases were included, in which 52 were for healthy control group and 23 were for GDM group. Then the number and differentiation status of HSCs in cord blood of the two groups were observed. HSC (CD45+ CD34+), CLP (CD45+ CD34+ CD7+) and CMP (CD45+ CD34+ CD33+) cells were identified and quantified by flow cytometry. Results Compared to healthy controls, HSC number in cord blood from GDM group were significantly increased (0.77±0.063% vs.1.28±0.176%，p=0.0113). The number of CMP cells which were differentiated from HSCs were higher than control (28.69±3.223% vs.46.43±4.927%, p=0.0033), while CLP cell number were lower (27.04±2.044% vs.21.11±2.406%, p=0.0475). Conclusion In conclusion, compared with non-diabetic pregnant women, there were more HSCs in the cord blood of the newborns of GDM patients, and the differentiation of HSCs to CMP cells was increased, while the differentiation to CLP cells was decreased. Those findings were probably caused by the high glucose microenvironment and insulin medication in pregnant women with GDM, and the HSCs differentiation changes might be influencing factors of the high incidence of neonatal erythrocytosis in GDM patients.