Diabetes in pregnancy and infant mortality: Link with glycemic control

To compare the clinical and glycemic profile as well as pregnancy complications and infant mortality among diabetic mothers in Indonesia.

Data was obtained from medical records of Internal-Medicine Clinic in Hermina Podomoro General Hospital during the period January-December 2015. Subjects were grouped into good and poor outcome groups based on infant mortality.

Forty-five subjects were obtained with an average age of 31 years, 41 had gestational diabetes mellitus while 4 had pregestational diabetes. Twenty-one patients had high-risk pregnancies (age >30 years or <20 years). No maternal mortalities were reported, only 6 pregnancies were complicated with infant death. Comorbidities mainly found were preeclampsia, anemia and urinary tract infection. Most patients delivered through caesarian section. Almost all of them were treated with insulin. Comparison between both groups showed that those with poor outcomes have a significantly higher body mass index prior to pregnancy, higher body weight prior and after pregnancy as well as worse glycemic profile.

Diabetes in pregnancy has been found to increase rates of infant mortality. This study showed that patients with poor glycemic control are at a greater risk of infant mortality. Therefore increased monitoring and prenatal care as well as optimal glycemic control for patients with diabetes in pregnancy is recommended. Optimal glycemic control will lead to diabetic mothers with pregnancies of equal risk and similar outcomes to those of normal patients.