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Clinical analysis of infants of diabetic mothers
Insights
Infants of diabetic mothers (IDMs) face significant risks, including congenital malformations and various morbidities. Tight maternal diabetes control before and during pregnancy is crucial for reducing adverse outcomes in these infants.
Area of Science:
- Neonatal Medicine
- Endocrinology
- Obstetrics
Background:
- Infants of diabetic mothers (IDMs) are at increased risk for perinatal complications.
- Maternal diabetes can lead to significant neonatal morbidities and mortality.
- Congenital malformations are notably higher in IDMs compared to the general neonatal population.
Purpose of the Study:
- To present the clinical spectrum of morbidities and mortality in infants of diabetic mothers (IDMs).
- To investigate the association between maternal glycemic control during organogenesis and congenital malformations in IDMs.
- To emphasize the importance of preconception and prenatal care for diabetic women.
Main Methods:
- Retrospective review of clinical data for 82 infants of diabetic mothers over 15 years.
- Analysis of perinatal mortality rates and observed morbidities in live-born IDMs.
- Comparison of maternal fasting plasma glucose levels between mothers with malformed and normal infants.
Main Results:
- Perinatal mortality rate was 6.1%.
- Common morbidities included large for gestational age (35.9%), hyperbilirubinemia (28.2%), and respiratory distress (17.9%).
- Congenital malformations occurred in 15.9% of IDMs, significantly higher than the general population, linked to higher maternal fasting glucose levels during organogenesis.
Conclusions:
- Tight control of maternal diabetes is essential to decrease mortality and malformation rates in IDMs.
- There is an urgent need for improved health education and supervision for diabetic women before and during pregnancy.
- Early and consistent management of diabetes in pregnancy can significantly improve neonatal outcomes.
Abstract:
The clinical spectra of 82 infants of diabetic mothers (IDMs) encountered in the past 15 years are presented. The perinatal mortality rate was 6.1%, The observed morbidities of the 78 live-born IDMs were: large for gestational age, 35.9%; prematurity, 12.8%; small for gestational age, 12.8%; respiratory distress, 17.9%; low Apgar score, 6.4%; nerve injury, 2.6%; hypoglycemia, 10.3%; hyperbilirubinemia, 28.2%; polycythemia, 12.8%; hypocalcemia, 5.1%; hypertrophic cardiomyopathy, 3.8%. Furthermore, 15.9% (13/82) of these infants suffered from congenital malformation, a rate nearly 10 times higher than that of the general neonatal population born in this hospital. In comparing sugar control during organogenesis, the mothers who had malformed infants had significantly higher fasting plasma glucose level than the mothers who had normal infants (P less than 0.05). Since tight control of maternal diabetes is mandatory to reduce the prevalence of mortality and malformation of the IDMs, we suggest that there is an urgent need to improve health education and supervision before and during pregnancy in all diabetic women.