A study of neonatal outcome in infants born to diabetic mothers at a tertiary care hospital
DOI:
https://doi.org/10.18203/2349-3291.ijcp20180541Keywords:
Glycemic control, Infant of diabetic mother, MacrosomiaAbstract
Background: Diabetes is the most common medical complication in pregnancy, affecting about 0.5-5% of all pregnancies. In developing countries, management of diabetes in pregnancy still poses a challenge. Infants of diabetic mother are at increased risk of periconceptional, fetal, neonatal and long-term complications.
Methods: It was a prospective hospital-based study conducted in tertiary care hospital, Bangalore during a period of one year to assess the outcome in infants of diabetic mother and association of various complications to maternal glycemic status.
Results: The incidence of diabetes in pregnant mothers in our hospital was 2.8%. Diabetic mothers with gestational diabetes mellitus (GDM) were 86 (86%) and with pre-gestational diabetes were 14 (14%). Various complications like hypoglycemia, hypocalcemia, polycythemia, hyperbilirubinemia, macrosomia, prematurity, respiratory distress syndrome, TTNB, congenital heart diseases were observed in infants of diabetic mothers. Among them hypoglycemia was the most commonly observed complication with frequency of 54%, followed by hypocalcemia which was seen in 43%, polycythemia in 35% and macrosomia in 15%. Significant association was found between various complications and glycemic control in mothers.
Conclusions: High frequency of complications is seen in infants born to diabetic mothers. Hence, these babies should be delivered at hospitals where special neonatal care is available for management of high risks babies. Screening for GDMs should be performed in all pregnant women. Strict glycemic control in mother, planned pregnancy, proper antenatal care and strict monitoring in babies is required to prevent morbidity and mortality in infants of diabetic mother.
References
Kasper, Dennis L. Harrison's principles of internal medicine. 19th edition. New York: McGraw Hill Education; 2015;2:2399-2427.
Jansen C, Greenspoon SJ, Palmer MS. Diabetes mellitus and pregnancy. Current Obstet Gynaecol Diag Treatment 9th ed; 2003;18:317-21.
Chmait R, Moore TR. Endocrine disorders in pregnancy: Avery’s diseases of the new-born, 8th ed; 2005:71-86.
American Diabetes Association. Clinical Practice recommendations. Diabetes Care. 2011;34(1).
Joan L, Nold MD, Michael K, Georgieff MD. Pediatr Clin N Am. 2004;51:619-37.
Murthy EK. Diabetes and pregnancy. Diabetologia Croatica. 2002:131-46.
HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358:2061.
Kliegman, Stanton. Infants of Diabetic mothers. Nelson textbook of pediatrics. 20th edition; 2015;107(1):897-989.
John P Cloharty, Eichenwald;Manual of Neonatal care; Diabetes Mellitus; chapter 2; 7th edition;p 11-23.
Kalhan SC, Parimi PS, Linsu CA. Pregnancy complicated by diabete mellitus. In: Fanaroff AA, Mortin RJ, editors. Neonatal perinatal medicine: diseases of foetus and infant. Philadelphia: Mosby; 2002:1357-61.
Case J, Willoughby D, Haley-Zitlin V, Maybee P. Preventing type 2 diabetes after gestational diabetes. Diabetes Educ. 2006;32:877-86.
Singh M. Care of Newborn. 8th edition. CBS Publishers and Distributors Pvt Ltd. 2016;4:83-4.
Prabhavathi R, Basavaraj, Pushpalatha K, Udaykumar S. A study of perinatal and neonatal outcome in infants born to diabetic mothers. Int J Adv Med. 2015;2:246-9.
Shirazi H, Raiz S. Neonatal outcome of diabetic pregnancy. Ann Pak Inst Med Sci. 2010;6(2):107-12.
Hussain M, Irshad M. Frequency of various neonatal complications in infants born to diabetic mothers: a hospital-based study. JPMI. 2001;25(3):227-32.
Thomas N, Chinta AJ. Perinatal outcome of infants born to diabetic mothers in a developing country- comparison of insulin and oral hypoglycaemic agents. Indian Paediatr. 2013;50:289-93.
Mimouni F, Miodovnik M, Siddiqi TA, Khoury J, Tsang RC. Perinatal asphyxia in infants of insulin-dependent diabetic mothers. J Pediatr. 1988;113(2):345-53.