Admissions to neonatal intensive care unit following pregnancies complicated by gestational or type 2 diabetes

When gestational diabetes mellitus (GDM) is diagnosed in a population with a high prevalence of unrecognised type 2 diabetes mellitus (type 2 DM), the rate of neonatal morbidity is not clear. There is also a paucity of data reporting neonatal outcome in women with recognised type 2 DM.

To describe, in a population with a high background prevalence of type 2 DM, neonatal morbidity in infants of women with GDM and type 2 DM admitted to the neonatal intensive care unit (NICU).

A 2-year audit was carried out in a tertiary level obstetric hospital with a multi-ethnic delivery population. All infants admitted to the NICU whose mothers had GDM or type 2 DM were identified from the hospital database. The records of 136 infants were retrospectively reviewed and data collected on outcome measures including maternal diagnosis, macrosomia, mode of delivery, delivery complications, hypoglycaemia, respiratory distress and congenital anomalies.

Admission to NICU occurred in 29% of GDM and 40% of type 2 DM pregnancies. Median gestation was 37 weeks (range: 25-41), with 46% delivered preterm. Forty percent of infants were delivered by emergency Caesarean section. Fifty-one percent of admissions had hypoglycaemia and 40% required support for respiratory distress. Women with type 2 DM diagnosed either prepregnancy or post-partum were the highest risk group for neonatal morbidity, including congenital anomalies.

Neonatal morbidity is common in infants of women with type 2 DM and GDM in a population with high prevalence of type 2 DM.