Introduction: Foetal growth and development is a complex process that involves the interrelationship among the mother, placenta and fetus. Both high and low birth weight infants are associated with the highest prevalence of diabetes. Women with diabetes are at greater risks, because of their pregnancy related complications. Objective: To compare the characteristics of groups of LGA (large for gestational age) babies born to prediabetic mothers (DM) and gestational diabetic mothers (GDM) with control infants born to apparently healthy non-diabetic mothers (NDM). Materials and Methods: This was a prospective cohort study of 251 newborn-mother pairs (n: DM=86; GDM=86 and NDM=79) recruited from the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka. Detailed anthropometric measurements of infants were taken at birth in the hospital. LGA babies had birth weights greater than the 90th percentile for their gestational age for sex and SGA (small for gestational age) babies usually had birth weights below the 10th percentile for babies of the same gestational age for sex. Results: Only 10(11.6%) babies were found LGA in the GDM group as opposed to 3 each for DM and NDM group. There was a significant group difference in the incidences of SGA babies. Around 16% to 18% were there in the DM and GDM groups, as opposed to much higher rate (30.4%) in the NDM group. Conclusion: Newborns from both DM and GDM groups showed greater values compared to that of the NDM group in all anthropometric measures except length and head circumference suggesting intrauterine growth acceleration in them. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 117-123
Background: The growth of infants born to diabetic mothers is at greater risks because of their pregnancy related complications.Objectives: This study concerns comparison of BMI changes in different periods of infants born to pre-diabetic mothers (DM) and gestational diabetic mothers (GDM) with control infants born to apparently healthy non-diabetic mothers (NDM).Materials & Methods: This study comprising 251 newbornmother pairs (n: DM=86; GDM=86 and NDM=79) recruited from the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka.Results: BMI at birth was significantly higher for DM (BMI: 13.3±0.2 vs.12.6±0.2; p=0.003) and GDM (BMI: 13.7±0.2 vs.12.6±0.2; p<0.001) groups compared to the NDM group. On paired t tests, BMI increased significantly during 0-3 month period and 3-6 months periods in all groups (DM, GDM and NDM). At 0 month, compared to babies in the NDM group, mean BMI z-scores were significantly higher for the DM (-0.095±1.2 vs. -0.73±1.4; p=0.003) and GDM (0.16±1.4 vs.-0.73±1.4; p<0.001) groups. On paired-samples t tests, BMI Z-scores decreased from birth to 3 month of age in DM and GDM groups, but this decrease was significant for the GDM group only. In subsequent periods, BMI z-scores increased in all groups but the increment was more evident in GDM and NDM groups.Conclusion: At 0 month (birth), compared to babies in the NDM group, mean BMIs were significantly higher for the DM and GDM groups which became normalised by 3rd month when they got rid of maternal metabolic influences. The changes in BMI Z-score during 9-12 months period were significantly positive for NDM group compared to others.KYAMC Journal Vol. 8, No.-2, Jan 2018, Page 13-17
To compare the maternal and fetal outcome in multiple versus singleton pregnancies in a private teaching hospital in India. Prospectively collected data on 50 twin deliveries from July 2018 to November 2021 were studied to determine its incidence; the maternal and foetal outcome, and compared with 50 singleton deliveries conducted on same day following the twin delivery who served as controls, the twins were also analysed on the basis of chorionicity. A total of 3415 deliveries were conducted during the study period, of which 50 were twin deliveries, giving an incidence of 14 per 1000 births or 1.4:100 deliveries. Six among 50 twins resulted following ovulation induction. Women with twin gestation had a mean maternal age of 24.7±3.71, same for the singleton mothers was 24.26±3.7years; mean gestational age at delivery for twins and singletons were 35.38±2.6 and 38.63±1.19 weeks; mean birth weight for twins and singletons were 2.193kgs and 2.85±0.46kgs, mean parity were 2.04± 1.0 and 1.72±0.7 respectively. Parity, gestational age, NICU stay characteristics showed p value < 0.05. Compared with singletons, women with twin gestations had a positive risk association with odds >1 for anaemia, preeclampsia, preterm labour, malpresentation and caesarean delivery. Twin Neonates suffered prematurity, low birth weight, congenital anomaly, prolonged NICU care and increased perinatal death. Neonatal risk was more among monochorionic twins than dichorionic twins. There were 3 cases with single fetal demise, and both fetuses IUD in another case, (total IUDs-5), one twin was still born, two had early neonatal death and there were two late neonatal (>7 Days) deaths. One twin mother threw fits on the 6th postpartum day. Another mother received 20 units of blood and component replacement and subtotal hysterectomy for PPH. Despite improvement in antenatal and neonatal care, twins pose a higher threat to MCH outcome. Hence, thorough counselling, patient awareness, more vigilance at interpretation of antenatal tests, intrapartum monitoring and bridging the gap between demand and supply at NICU facility can improve maternal and neonatal outcome; as well as can help parents cope with the psychological stress.
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