[Hypertrophy of neonates in diabetic mothers and their long-term prognosis]

Area of Science:

• Endocrinology
• Neonatology
• Pediatric Endocrinology

Context:

• Infants born to diabetic mothers (IDMs) are at increased risk for adverse outcomes.
• Neonatal hypertrophy is a common complication in IDMs.
• Long-term follow-up of IDMs is crucial for understanding developmental trajectories.

Purpose:

• To investigate the long-term prognosis of neonates with hypertrophy born to diabetic mothers.
• To assess the association between neonatal hypertrophy and subsequent health deviations in offspring.
• To determine the influence of neonatal hypertrophy on the development of diabetes and metabolic abnormalities.

Summary:

• A cohort of 175 infants of diabetic mothers was followed up to a mean age of 20.75 years.
• Neonates with marked hypertrophy exhibited higher rates of hypoglycemia, asphyxia, respiratory distress, and neurological symptoms.
• Adult offspring, regardless of neonatal hypertrophy, showed increased prevalence of hyperglycemia and hyperinsulinemia during oral glucose tolerance tests compared to controls. Diabetes incidence was similar in hypertrophic (8.7%) and non-hypertrophic (8.0%) IDM groups. Adult indicators were not associated with birth weight or hypertrophy degree, with genetics identified as the primary determinant for diabetes development.

Impact:

• Neonatal hypertrophy in IDMs is linked to immediate complications but not necessarily a higher long-term risk of developing diabetes.
• Offspring of diabetic mothers exhibit persistent metabolic alterations, including higher blood glucose and insulin levels.
• Genetic predisposition appears to be a more significant factor in the development of diabetes among offspring of diabetic mothers than neonatal size.