Factors influencing neonatal morbidity in gestational diabetic pregnancy

Nordlander, E; Hanson, Ulf; Persson, Bengt

doi:10.1016/0020-7292(90)90733-2

Cited by 5 publications

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“…[21][22][23][24][25][26] Among 261 Swedish women with GDM, the incidence of preeclampsia and gestational hypertension combined was significantly higher than among women in a control group with uncomplicated pregnancy (14% versus 7%). 21 In another study, the incidence of preeclampsia was slightly higher among women with GDM diagnosed in the third trimester (7.5%) and significantly higher among women with diabetes diagnosed at Ͻ24 weeks' gestation (14.7%) than among women with normal glucose tolerance (5.4%). 24 However, these findings remain controversial because other studies have not observed a higher frequency of PIH in gestational diabetic women.…”

Section: Gestational Diabetes Mellitusmentioning

confidence: 99%

Brief Review: Hypertension in Pregnancy

2001

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Abstract-Pregnancy-induced hypertension (PIH), which includes both gestational hypertension and preeclampsia, is a common and morbid pregnancy complication for which the pathogenesis remains unclear. Emerging evidence suggests that insulin resistance, which has been linked to essential hypertension, may play a role in PIH. Conditions associated with increased insulin resistance, including gestational diabetes, polycystic ovary syndrome, and obesity, may predispose to hypertensive pregnancy. Furthermore, metabolic abnormalities linked to the insulin resistance syndrome are also observed in women with PIH to a greater degree than in normotensive pregnant women: These include glucose intolerance, hyperinsulinemia, hyperlipidemia, and high levels of plasminogen activator inhibitor-1, leptin, and tumor necrosis factor-␣. These observations suggest the possibility that insulin resistance may be involved in the pathogenesis of PIH and that approaches that improve insulin sensitivity might have benefit in the prevention or treatment of this syndrome, although this requires further study. (Hypertension. 2001;37:232-239.)

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Section: Gestational Diabetes Mellitusmentioning

confidence: 99%

Brief Review: Hypertension in Pregnancy

2001

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“…[3][4][5] Suboptimal prenatal care along with poor maternal glycemic control, vasculopathy, infection, and pregnancy-induced hypertension are factors associated with poor perinatal outcome. 1,6,7 Congenital malformations, [8][9][10] macrosomia, 3,11,12 respiratory distress syndrome (RDS), 13,14 hypoglycemia, 3,[15][16][17] hyperbilirubinemia 18 and hypocalcemia 19 are some of the conditions most frequently diagnosed in the offspring of diabetic women.…”

mentioning

confidence: 99%

Management of Infants of Diabetic Mothers

Cordero¹,

Treuer²,

Landon³

et al. 1998

Arch Pediatr Adolesc Med

139

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To describe the clinical outcome of infants born to mothers with gestational diabetes mellitus (GDM) and preexisting insulin-dependent diabetes mellitus (IDDM).Setting: A tertiary care regional perinatal center with a specialized diabetes-in-pregnancy program.Design: Case series.Results: Five hundred thirty infants were born to 332 women with GDM and 177 women with IDDM. Thirty-six percent of these 530 newborns were large for gestational age, 62% were appropriate for gestational age, and only 2% were small for gestational age. Seventy-six (14%) of all infants were born before 34 weeks' gestation, 115 (22%) between 34 and 37 weeks of gestation, and 339 (64%) at term. Two hundred thirty-three infants (47%) were admitted to the neonatal intensive care unit due to respiratory distress syndrome(RDS),prematurity,hypoglycemia,orcongenitalmalformation. Hypoglycemia (more common among infants of maternal diabetic classes C through D-R) was documented in 137 (27%) of all newborns. One hundred eighty-two infants (34%) had RDS of varying severity. Polycythemia (5% of infants), hyperbilirubinemia (25%), and hypocalcemia (4%) were other morbidities present. Two hundred fortyfour infants were admitted for routine care and enteral feedings. Forty-three of these newborns required subsequent transfer to the neonatal intensive care unit for treatment of hypoglycemia (16 cases), RDS (19 cases), or both (8 cases). Routine care failures were more common among infants whose mothers had advanced diabetes, but less frequent among breast-fed infants.Conclusions: With modern management, fewer morbidities can be expected in infants of diabetic mothers. Those infants born to women with IDDM remain at risk for hypoglycemia, which can be treated in one half of the cases by enteral feedings alone. The majority of cases of RDS are mild and require short admissions to special care nurseries. Optimal care of infants of diabetic mothers is based on prevention, early recognition, and treatment of common conditions.Severecongenitalmalformations,significantprematurity,RDS,recurrenthypoglycemicepisodes,andasymptomatic infants of women with advanced IDDM should be admitted to special care nurseries. Breast-feeding among women with GDM and IDDM should be encouraged.

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“…However, E. Nordlander reported mean age of 31 years. 3 This may be because of late marriages in western countries. Several studies in the past have stated that gestational diabetes is seen in with higher frequency in women beyond the age of 25.…”

Section: Discussionmentioning

confidence: 99%

Descriptive Study of Gestational Diabetes Mellitus and Its Outcome in a Central Indian Hospital

Thakare¹,

Wankhede²

2017

jemds

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BACKGROUNDGestational diabetes mellitus is one of the common complications of pregnancy. It has implications for both mother and the baby. Untreated GDM leads to increased perinatal morbidity and mortality. For the mother, GDM is a very strong risk factor for the development of permanent diabetes in later life. Hence, identification of risk factors and early diagnosis with proper institution of treatment is of paramount importance. Aim-The aim of this study was to study the pregnancy outcome in diagnosed cases of gestational diabetes mellitus. Design-This is a descriptive study. MATERIALS AND METHODSThis was a descriptive study conducted over a period of 2 years in a tertiary care hospital in central India; 90 study subjects were included. All cases were clinically assessed and investigated according to severity of GDM. Appropriate treatment was instituted and they were followed till term. Labour was monitored and the outcome of pregnancy was noted. All data collected was analysed. Results were expressed as numbers and percentages. RESULTSThe highest incidence of GDM was seen in primigravidas 42.22% and the mean age was 26.5%; 10% cases had history of GDM in previous pregnancy and 14.4% had a family history of diabetes. Insulin in addition to diet control was required in 58.8% cases. Macrosomia was seen in 4.5%. Incidence of IUD was 2.7%, whereas 3.6% study subjects gave birth to congenitally anomalous babies. Incidence of caesarean section was 48.9% and that of PIH was 13. CONCLUSIONUniversal screening rather than screening only those patients having risk factors of GDM should be the norm, as GDM mothers and their babies are at increased risk of unfavourable maternal and foetal outcome. Timely diagnosis and effective glycaemic control by instituting appropriate treatment can decrease if not prevent the maternal and foetal complications to a large extent.

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Factors influencing neonatal morbidity in gestational diabetic pregnancy

Cited by 5 publications

References 0 publications

Brief Review: Hypertension in Pregnancy

Brief Review: Hypertension in Pregnancy

Management of Infants of Diabetic Mothers

Descriptive Study of Gestational Diabetes Mellitus and Its Outcome in a Central Indian Hospital

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