Neonatal glycemic status of infants of diabetic mothers in a tertiary care hospital

Abstract

Background:Diabetes is a common medical complication during pregnancy that results in significant neonatal morbidities. In infants of diabetic mothers (IDMs), hypoglycemia is a common complication.Objective:To study the neonatal hypoglycemia in IDMs in a tertiary care hospital.Settings and Design:A cross-sectional study was done in postnatal ward in Bangladesh Institute of Research and Rehabilitation in Diabetic, Endocrine and Metabolic Disorders from January to December 2009.Subjects and Methods:The data of IDMs were collected from postnatal ward. All IDMs delivered during this period staying in postnatal ward were included in this study. The outcomes were compared between the hypoglycemic and normoglycemic IDMs and between gestational diabetes mellitus (GDM) and pre-GDM in hypoglycemic group using Chi-square test and Fisher's exact test. The data analysis was performed with Epi-enfo7 software. Statistical significance was set at P < 0.05.Results:A total of 363 IDMs were included in this study. Hypoglycemia developed in 38.3% IDMs and 43.2% mothers of hypoglycemic IDMs had GDM and 56.8% had pre-GDM. Duration of maternal diabetes (P = 0.04) and large for gestational age (P = 0.0001) were associated with hypoglycemia. Multigravidae (82.2% vs 68.3%, P = 0.03), prolonged duration of maternal diabetes (45.46 weeks vs 3.23 weeks, P = 0.00001), preterm babies (48.1% vs 28.3% P = 0.009), and control of diabetes by insulin (81% vs 46.7%, P = 0.001) were more in pre-GDM, and statistically significant. About 85% IDMs developed hypoglycemia within 6 h of birth (P-value 0.00001) and majority (68%) were at 2 h of age. Forty percent of hypoglycemic IDMs from postnatal ward were admitted in special care baby unit.Conclusion:Hypoglycemia observed in 38.3% IDMs and developed within 6 h of age and maximum were at 2 h. Early recognition and appropriate intervention are needed in IDMs.

Risk Belirlenen Bebeklerde Hipoglisemi İnsidansı

“…Infants of diabetic mothers commonly experience hypoglycemia in the first hours after birth. However, the infants of diabetic mothers treated with diet did not have any association with hypoglycemia, while a significant increase in the frequency of hypoglycemia was observed in those born to mothers treated with insulin or oral agents (19,20). Our findings were in line with this result.…”

Frequency of Neonatal Hypoglycemia Among Women Diagnosed with Maternal Hyperglycemia

“…On other hand Magadla Y et al 15 reported that the average maternal age was 33 years, with a range of 18-44 years. In the study of Begum S et al 13 reported that the majority mothers were between 21 and 40 years of age and mostly were multigravida, while in this study primiparous women were found in majority.…”

“…In this study the frequency of neonatal hypoglycemia was observed among 24.8% of the cases. Similarly, Begum S et al 13 reported that the Hypoglycemia was observed among 38.3% infants of the diabetes mothers. However, Saqib M et al 14 observed lower rate of neonatal hypoglycemia as 14.8% among diabetes mothers.…”

“…In this study, caesarean section was done in 62.4% cases. Study conducted by Begum S et al 13 reported that around 96% of the neonates were delivered via C-sections and the average gestational age was around 36.5 weeks. However, in this study mean gestational age was 37.85±3.11 weeks.…”

The Health of Infants Born to Mothers with Gestational Diabetes Mellitus

“…Один из наиболее обсуждаемых вопросов -влияние терапии ГСД, получаемой во время беременности, на частоту гипогликемии новорожденного. Тогда как некоторые исследователи отмечают более высокую частоту гипогликемии у детей при применении инсулинотерапии во время беременности (по сравнению с таковой при использовании диеты или пероральных антидиабетических средств) [25,26], другие такую зависимость не выявляют [27]. Возможно, риск неонатальных осложнений обусловлен не характером терапии, а тем, что пациентки, имеющие потребность в инсулине, отличались более высоким «базовым» риском, прегестационным ожирением, чрезмерным ГУМТ и другими отягчающими факторами.…”