Birth weight, gestational age, and perinatal deaths in 5,471 infants of diabetic mothers

1977 ◽  
Vol 90 (3) ◽  
pp. 444-447 ◽  
Author(s):  
A. Frederick North ◽  
Sati Mazumdar ◽  
Vito M. Logrillo
Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jenny E Zablah ◽  
Dorota Gruber ◽  
Denise A Hayes

Introduction: Infants of diabetic mothers (IDMs) with cardiac hypertrophy are recognized to have impaired myocardial performance, but less is known about ventricular function in those without hypertrophy. We hypothesized that, in asymptomatic newborns with normal echocardiograms, tissue Doppler imaging (TDI) indices of cardiac function would be decreased in IDMs compared to controls. Methods: This retrospective case-control study involved IDMs ≥ 36 weeks gestational age, at 0 to 7 days of life. Subjects with cardiorespiratory symptoms, ventricular hypertrophy or dysfunction, or any echocardiographic abnormality (other than a patent ductus arteriosus before 4 days of life, or a patent foramen ovale) were excluded. Each subject was matched with 3 controls (healthy infants of non-diabetic mothers) by age (0-24, 25-48, 49-72, or > 72 hours of life), birth weight (± 0.5 kg), body surface area (± 0.03 m 2 ), and by the ultrasound system utilized. TDI systolic (S’), early diastolic (E’), and late diastolic (A’) velocities were measured at the mitral valve (MV) annulus, basal ventricular septum, and tricuspid valve (TV) annulus, and were averaged from 3 consecutive cardiac cycles. Early Doppler inflow velocity to E’ ratios (E/E’) were calculated. Results: Seventy cases (39 male) were identified: first 24 hours (h) of life (n=18), 25-48 h (n=22), 49-72 h (n=14), and > 72 h (n=16). Maternal diabetes was gestational in 60 cases, and pre-existing in 10. Median gestational age was 38 6/7 weeks (range 36-41 2/7), median birth weight 3.65 kg (2.56-5.38), and median BSA 0.22 m 2 (0.17-0.27). Ultrasound system vendors included Siemens ® (n=46), Philips ® (n=23), and General Electric ® (n=1). Cases were matched with 210 controls. IDMs had significantly lower S’ ( p ≤ 0.05) and E’ ( p ≤ 0.01) velocities, and significantly higher E/E’ ratios ( p ≤ 0.01) at the MV, basal septum, and TV compared to controls (Wilcoxon rank-sum test). There were no significant differences in A’ values between groups. Intraclass correlation demonstrated 84-99% interobserver and 98-99% intraobserver reliability. Conclusions: In asymptomatic newborn IDMs without cardiac hypertrophy, TDI suggests a subclinical decrease in systolic and diastolic myocardial function compared to controls.


2012 ◽  
Vol 31 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Ljubomir Milašinović ◽  
Ivan Hrabovski ◽  
Zorica Grujić ◽  
Mirjana Bogavac ◽  
Aleksandra Nikolić

Biochemical and Physiological Characteristics of Neonates Born to Mothers with Diabetes During GestationThe aim of this study was to investigate how glucose homeostasis disorders influence biochemical homeostasis and fetal maturation. A prospective randomized study included 102 infants: 31 newborns of mothers with glucose homeostasis disorders (Group I) and 71 newborns of healthy mothers (Group II). In the pregnant women, the mean age, body weight and height, BMI, parity, duration of the disease and the mode of labor were estimated. The following procedures were performed in each newborn infant: physical examination, determination of Apgar score, measurements of birth weight and length, estimation of neurological status, clinical estimation of gestational age, ECG and ultrasonography of the brain, as well as the basic hematologic, biochemical and microbiological analyses. Newborn infants of diabetic pregnancies were small for gestational age and of high birth weight. The levels of Na+, K+and Cl-ions did not show significant differences between the investigated groups, whereas the levels of total Ca and Mg were significantly decreased (2.18±0.59 and 0.65±0.17 mmol/L) (p<0.001) in the investigated group relative to the control group (2.42±0.53 and 0.81±0.09 mmol/L). The newborn infants of diabetic pregnancies presented with significantly decreased values of phosphates, bicarbonates and pH, whereas the difference in total osmolality was not statistically significant. The level of glucose at birth in the infants of diabetic mothers was lower (2.91±0.51 mmol/L) (p<0.001) than in the infants of healthy pregnancies (3.94±0.29 mmol/L). Glycemia lower than 2 mmol/L was recorded in 6.5% of infants of the investigated group. The level of bilirubin was significantly increased (209.71±56.66 mmol/L) (p<0.001) in infants of diabetic mothers compared to those of the healthy ones (155.70±61.14 mmol/L), like the incidence of clinically manifested hyperbilirubinemia. Disorders of maternal glucose homeostasis cause biochemical disorders such as hypoglycemia, hypocalcemia, hyperbilirubinemia, hypomagne semia and are associated with impaired maturation and congenital malformations of the fetus.


2018 ◽  
Vol 16 (2) ◽  
pp. 25-30
Author(s):  
Taslima Begum ◽  
Gulshan Ara Begum ◽  
Mahmood A Chowdhury ◽  
Wazir Ahmed ◽  
Md Badrudddoza

Background: Infants are considered Large for Gestational Age (LGA)if their birth weight is greater than the 90th percentile for gestational age. Birth weight is influenced by a number of factors with maternal diabetes being one of the most common risk factor affecting birth weight. They have an increased risk for adverse perinatal outcomes. The aim of the present study was to compare the neonatal outcomes of LGA infants delivered by women with and without gestational diabetes mellitus.Methods: This is a prospective study of all live-born LGA infants of 37 weeks of gestation with a birth weight of 4000g admitted at Neonatal ward of Chattagram Maa Shishu-O-General Hospital (CMSOGH) between 1st August 2013 to 31st July 2014. Type of sampling was purposive convenient sampling. A total of 51 neonatal patients were included. Data was collected in case record form. Data collected for the mothers included age, parity, gestational age and mode of delivery. Data for the infants include sex, birth weight, birth length and laboratory test. Outcomes were compared between infants of diabetic mothers (Group A) and infants of non- diabetic mothers (Group B). Then data was analyzed by SPSS 17.0 program and presented by tabular method, diagram and chart.Results: Among fifty one study subjects, thirty were Infants of Diabetic Mothers (IDMs) while twenty one were non- IDMs. 19 (63.3%) of the IDMs were male while 11 (36.7%) were female. Among the 21 non-IDMs 10 (47.6%) were male and 11 (52.4%) were female. Male to female ratio was 1.4:1. 5 (16.7%) of the IDMs were delivered vaginally while 25 (83.3%) were delivered by Caesarian Section (CS) where as 8 (38.1%) of the non- IDMs were delivered vaginally while 13 (61.9%) were delivered by CS. Respiratory distress was the most common morbidity affecting 70% of the IDMs and 66.7% of the non-IDMs. TTN accounted for the majority of the respiratory distress cases, occurring in 17 of the IDMs and 12 of the non-IDMs. Regarding analysis of other clinical features, convulsion (63.3%) was present more in IDMs than in non-IDMs (52.4%) cyanosis was found more in IDMs (60%) than non-IDMs (38.1%). Hypoglycemia was found more in IDMs than in non-IDMs. Mean glucose values were 41.06±19.91mg/dl for IDMs and 53.06±28.96mg/dl for the non-IDMs (p=0.001). Hyperbilirubinemia was more frequently observed in IDMs than in non- IDMs. About 17 (56.6%) of the IDMs and 7(33.3%) of the non-IDMs developed jaundice during the period of hospital stay. Polycythemia was not observed in both the groups but PCV was higher in IDMs (53.96±6.36) compared to non-IDMs (50.50±8.76). Hypocalcemia was not peculiar to a specific group. Five of the IDMs had congenital anomaly, of which three of them had cardiac anomaly. One of the non-IDM was suffering from ventricular septal defect. Birth asphyxia was observed more in non-IDMs (71.4%) than in IDMs (53.3%).One of the IDMs and two of the non-IDMs sustained a brachial plexus injury following vaginal delivery. On an average, IDMs had a longer duration of hospital stay. Outcome was more fatal in IDMs. About six (20%) of IDMs died compared to two (9.5%) of the non-IDMs. That was found statistically significant (p=<0.05).Conclusion: LGA babies with diabetic mother had more adverse outcome in terms of mortality and blood glucose level. More concentration is needed to control blood glucose of mother during pregnancy. Also extra care for the babies is needed to avoid fatal neonatal outcomes.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 25-30


2014 ◽  
Vol 2 (02) ◽  
pp. 34-40 ◽  
Author(s):  
Girish Gopal

Background:Diabetes has long been associated with maternal and perinatal mobidity and mortality. Infants of diabetic mothers (IDMs) have higher risks for serious problems during pregnancy, delivery and early neonatal period. Abnormal fetal metabolism during pregnancy which is complicated by maternal diabetes mellitus results in multiple neonatal sequelae. Objective: To study the clinical, metabolic and hematological profile in infants of diabetic mothers and to compare the neonatal outcome in gestational and pregestational (overt) diabetic mothers. Methods: 69 neonates born to diabetic mothers were enrolled in the study. Gestational age, birth weight, relevant perinatal history and examination findings were recorded. Blood samples were collected to perform relevant biochemical tests and managed as per unit protocol. Echocardiography and ultrasound abdomen was done routinely in all neonates. Results: Of the 69 neonates, 71.01% (49/69) were born to mothers with gestational diabetes mellitus (GDM), while the remaining 28.99% (20/69) were born to mothers with pregestational (overt) diabetes mellitus (PGDM). 53.63% (37/69) of mothers had poor glycemic control. Most of the neonates (73.91% - 51/69) were delivered by cesarean section. 88.40% (61/69) of the babies were born at term. Majority of them (85.50% - 59/69) were appropriate for gestational age with mean birth weight of 3.06±0.82kgs. Hypoglycemia was the most common metabolic abnormality seen in 73.91% (51/69) of neonates. Polycythemia was seen in 60.80% (42/69) of neonates. Congenital malformations were seen in 17.40% (12/69) of neonates, of which most of them had congenital heart disease. 11.60% (8/69) of the babies had suffered birth injuries. 5.80% (4/69) of neonates died in the early neonatal period. Occurrence of hypoglycemia, polycythemia, hyperbilirubinemia, congenital anomalies and birth injuries were significantly higher in infants born to mothers with GDM, whereas hypocalcemia and hypomagnesemia were significantly higher in infants of mothers with PGDM. Conclusions: Among the pregnancies complicated by diabetes, GDM continues to have a major contribution. Hypoglycemia and polycythemia remain the most common biochemical and hematological abnormality respectively. Congenital heart disease forms a major proportion of the congenital anomalies seen in IDMs. Mortality rate is higher in infants born to mothers with GDM.


1992 ◽  
Vol 38 (10) ◽  
pp. 2002-2007 ◽  
Author(s):  
M Speich ◽  
A Murat ◽  
J L Auget ◽  
B Bousquet ◽  
P Arnaud

Abstract Concentrations of magnesium (Mg), total calcium (Ca), phosphorus (P), copper (Cu), and zinc (Zn) were investigated in plasma (Pl) and erythrocytes (Erc) of venous cord blood of 44 infants of diabetic mothers (IDMs). These same concentrations plus total glycohemoglobin and fructosamine were determined at delivery in a subset of 15 mothers of these infants. Mineral results for IDMs were compared with those for 66 apparently healthy newborns. The duration of gestation in the two groups was significantly different (P &lt; 0.001). After adjustment for gestational age, the mean (+/- SD) differences between groups were significant for birth weight, head circumference, Erc-Mg (1.71 +/- 0.17 for IDMs vs 1.76 +/- 0.15 mmol/L for control subjects), Pl-Ca (1.96 +/- 0.32 vs 2.48 +/- 0.22 mmol/L), Pl-P (1.99 +/- 0.40 vs 1.57 +/- 0.25 mmol/L), and Erc-Cu (10.9 +/- 2.41 vs 12.9 +/- 3.00 mumol/L), but not for Erc-Zn (33.0 +/- 18.3 vs 40.4 +/- 13.6 mumol/L). The variable that best discriminated between the two infant groups after adjustment for gestational age was Pl-Ca. In the 15 mothers, Pl-Mg (0.67 +/- 0.07 mmol/L) and Pl-Ca (1.66 +/- 0.21 mmol/L) concentrations were low, Pl-Zn (9.81 +/- 3.40 mumol/L) was normal, and Pl-Cu (33.5 +/- 10.7 mumol/L) was above normal. Correlations between total glycohemoglobin and mineral values of the mothers or paired IDM mineral values were not significant. The concentration of Pl-Ca was positively correlated with Erc-Cu (P &lt; 0.001) and Pl-Cu (P &lt; 0.05) in the comparison group newborns but not in the IDMs.


1974 ◽  
Vol 77 (3_Suppl) ◽  
pp. S81-S86 ◽  
Author(s):  
B. Nørgaard-Pedersen ◽  
J. G. Klebe

ABSTRACT Erythrocyte carbonic anhydrase (CA) concentration B and C and the α1-fetoprotein (AFP) concentration was determined in cord blood from 45 newborn infants of diabetic mothers (IDM). The concentration of these quantities has separately been compared with the corresponding concentration in cord blood from normal newborn infants with the same gestational age. No difference was found except for AFP, where a significantly (P < 0.05) higher concentration was found in some infants of insulin treated diabetic mothers.


2012 ◽  
Vol 6 (2) ◽  
pp. 24-26
Author(s):  
A Giri ◽  
AS Tuladhar ◽  
H Tuladhar

Aims: This study was conducted to evaluate maternal characteristics and obstetric outcomes among women with hyperemesis gravidarum during pregnancy. Methods: A prospective hospital based study was conducted at Nepal medical college and teaching hospital over the period of two years where all the women admitted with history of hyperemesis gravidarum were evaluated. Hyperemesis gravidarum was defined as intractable nausea/vomiting in pregnancy that leads to dehydration, nutritional deficiency, electrolyte and metabolic disturbances and considerable ketonuria that may require hospitalization. The age of women, parity, gestational age, method of treatment and duration of hospital stay were analysed.The fetal outcome evaluated were incidence of preterm birth, apgar score <7 at 5 mins of birth, low birth weight, perinatal deaths and congenital anomalies in baby. Results: There were 52 women admitted with hyperemesis gravidarum among all obstetric admission (N= 2080). The incidence of hyperemesis gravidarum was 2.5% of all pregnancy. The condition was seen more commonly in nulliparous (61.5%) than in multiparous women. It was less common in women of parity 3 or more. The problem was identified maximum (50%) in gestational age of 5-7 weeks though one case was seen in gestational age of 20 weeks also. The mainstay of treatment was supportive. The range of hospital stay was 1-10 days with mean hospital stay 2.26 days. The preterm delivery rate was 4.8% and none of the babies were low birth weight. All the babies had apgar score >7 at 5 mins of birth. There were no congenital anomalies and no perinatal deaths were noted. Conclusions: Women with hyperemesis gravidarum did not have adverse obstetric outcome in this study. NJOG 2011 Nov-Dec; 6 (2): 24-26 DOI: http://dx.doi.org/10.3126/njog.v6i2.6752


1997 ◽  
Vol 82 (12) ◽  
pp. 3993-3997 ◽  
Author(s):  
Alexandre Lapillonne ◽  
Sophie Guerin ◽  
Pierre Braillon ◽  
Olivier Claris ◽  
Pierre D. Delmas ◽  
...  

A previous study using single photon absorptiometry has reported low bone mineral density of the radius in infants of diabetic mothers. The aim of this study was to assess by dual x-ray absorptiometry the whole body bone mineral content (WbBMC) and the body composition of 40 infants of diabetic mothers at birth (mean gestational age ± sd, 37.5 ± 1.3 weeks; mean birth weight ± sd, 3815 ± 641 g). WbBMC was not correlated with gestational age, but was well correlated with birth weight (r = 0.73; P = 0.0001) and also with fat mass (r = 0.87; P = 0.0001) and lean mass (r = 0.42; P = 0.008). The z-scores ± sd adjusted for weight for WbBMC and fat mass were significantly increased (1.3 ± 0.9 and 2.6 ± 1.3, respectively (P &lt; 0.0001), but were not significantly influenced either by in utero growth or by the type of the diabetes mellitus of the mother. Bone mineralization and fat mass studied by whole body dual x-ray absorptiometry are increased at birth in these infants compared with reference curves.


2017 ◽  
Vol 24 (3) ◽  
pp. 105
Author(s):  
Yulisa Haslinda ◽  
Budi Prasetyo

Objectives: to determine the frequency distribution of perinatal mortality and maternal characteristic features in terms of age, parity, gestational age and pregnancy complications in Dr.Soetomo Hospital Surabaya in 2015. Materials and Methods: A descriptive study conducted by collecting data on patients who experienced perinatal mortality of infants born from January to December 2015 in Dr. Soetomo, Hospital Surabaya. Samples were collected using total sampling. The samples must meet the following criteria: mothers of infants with perinatal mortality in Dr. Soetomo Hospital, Surabaya, from January to December 2015.Results: There were 206 perinatal deaths out of 1018 births in Dr. Soetomo during 2015, of which 58% was live birth and 42% was stillbirth. Most of perinatal mortality found in the preterm gestational age as much as 78%, and gestational age 28-<37 weeks (58%). Most of perinatal mortality occured in infants with less than 1500 grams birth weight, which was as much as 53% of all perinatal deaths and infant whose birth weight from1500 to 2500 grams was about 29%. Most perinatal mortality found in multigravida (54%) and in infants whose mothers experienced preeclampsia in pregnancy complications (35%), followed by infant mortality in women with non-obstetric complications (23%).Conclusion: Perinatal mortality in Dr. Soetomo Hospital was mostly found in multigravida mothers, 16-35 years old maternal age, 28-37 weeks gestational age and those with complications of preeclampsia.


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