Maternal Insulin Therapy Increases Fetal Endothelial Progenitor Cells During Diabetic Pregnancy

E ndothelial progenitor cells (EPCs)are bone marrow–derived cells in-volved in endothelial homeostasis and angiogenesis. Reduction and dys-function of EPCs have been associated with the development of atherosclerosis and diabetic complications (1,2). Recent studies in human pregnancies suggest that a mother’s EPCs are involved in the physiologic vascular remodeling of systemic and utero-placental circulation (3,4). Hyperglycemia induces dysfunc-tion and apoptosis of EPCs (5); this may impair the development or maturation of the utero-placental circulation, causing maladaptive responses during diabetic pregnancies. Indeed, EPCs have been shown to be dysregulated in pregnant women with diabetes (4). Little is known about the effects of maternal factors on fetal EPCs. One study showed reduced cord blood EPCs in se-vere preeclampsia (6), but there were no data on diabetes. This study was under-taken to evaluate quantitative alterations of cord blood progenitor cells during di-abetic pregnancies