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[Neonatal morbidity of children of diabetic mothers]
1Gynäkologisch-Geburtshilfliche Abteilung, Städtischen Krankenhauses München-Schwabing.
Insights
Infants born to diabetic mothers face higher risks of neonatal morbidity, including macrosomia and hypoglycemia, especially with poorer maternal metabolic control and advanced diabetes complications. Birth weight and maternal diabetes type significantly influence these risks.
Area of Science:
- Neonatalogy
- Endocrinology
- Public Health
Background:
- Maternal diabetes is a significant risk factor for adverse neonatal outcomes.
- Understanding the specific risks associated with different types of diabetes and their management is crucial for improving infant health.
Purpose of the Study:
- To assess neonatal morbidity in infants of diabetic mothers.
- To correlate neonatal outcomes with birth weight percentiles, maternal White classification, and glycemic control.
Main Methods:
- Analysis of neonatal symptoms in 51 infants of gestational/Type II diabetics and 148 infants of insulin-dependent diabetics.
- Evaluation of common neonatal complications: macrosomia, hypoglycemia, erythremia, hyperbilirubinemia, hypocalcemia, prematurity, and hyaline membrane disease.
- Statistical comparison across birth weight percentiles, maternal diabetes severity (White classification), and metabolic control levels.
Main Results:
- Hypoglycemia (34.3%) and macrosomia (24.6%) were prevalent. Higher birth weight correlated with increased hypoglycemia and erythremia.
- Infants of insulin-treated gestational diabetics had higher rates of macrosomia and hypocalcemia compared to diet-controlled groups.
- Insulin-dependent diabetics with retinopathy/nephropathy (White class FR) showed increased prematurity risk. Poor metabolic control led to higher rates of macrosomia and prematurity.
Conclusions:
- Neonatal morbidity is significantly influenced by maternal diabetes type, metabolic control, and disease progression.
- Birth weight and maternal diabetes complications are critical factors in neonatal outcomes.
- Optimizing metabolic control and managing diabetes-related complications in pregnancy can mitigate neonatal risks.
Abstract:
The purpose of the present study was to determine the risk of neonatal morbidity in infants of diabetic mothers in relation to birth weight percentiles, maternal White classification and metabolic control during pregnancy. The subjects consisted of 51 infants of gestational and Type II diabetic women and 148 infants of insulin-dependent diabetic women. The following neonatal symptoms commonly associated with maternal diabetes were analyzed: macrosomia, hypoglycemia, erythremia, hyperbilirubinemia, hypocalcemia, prematurity and hyaline membrane disease. The incidence of the symptoms was as follows: hypoglycemia in the first hour of life 34.3% macrosomia 24.6%, hyperbilirubinemia 23.7%, prematurity 18.1%, hypoglycemia after the first hour of life 16.6%, hypocalcemia 11.1%, erythremia 7.6%, and hyaline membrane disease 2.0%. There were statistically significant differences in the symptoms "hypoglycemia after the first hour of life" and "erythremia" between the birth weight percentile groups, i.e. the incidence of these symptoms increased with higher birth weights. The risk of neonatal morbidity among infants of insulin-treated gestational diabetics was higher than that of infants of diet-controlled gestational diabetic women. The incidence of macrosomia and hypocalcemia was significantly higher in the first group. Newborns of insulin-dependent diabetic women with proliferative retinopathy and/or nephropathy (White class FR) had an increased risk of neonatal morbidity in comparison to infants of White classes B, C, and D, especially with regard to prematurity and associated problems. Neonatal morbidity varies with the quality of metabolic control in women with insulin-dependent diabetes. Infants of poorly-controlled mothers were more often macrosomic and premature than infants of well-controlled mothers.