Incidence and risk factors for neonatal hypoglycaemia among women with gestational diabetes mellitus in South Auckland

Abstract Background There is increasing pressure to get women and babies home rapidly after birth. Babies born to mothers with gestational diabetes mellitus (GDM) currently get 24-h inpatient monitoring. We investigated whether a low-risk group of babies born to mothers with GDM could be defined for shorter inpatient hypoglycaemia monitoring. Methods Observational, retrospective cohort study conducted in a tertiary maternity hospital in 2018. Singleton, term babies born to women with GDM and no other risk factors for hypoglycaemia, were included. Capillary blood glucose (BG) testing and clinical observations for signs of hypoglycaemia during the first 24-h after birth. BG was checked in all babies before the second feed. Subsequent testing occurred if the first result was < 2.0 mmol/L, or clinical suspicion developed for hypoglycaemia. Neonatal hypoglycaemia, defined as either capillary or venous glucose ≤ 2.0 mmol/L and/or clinical signs of neonatal hypoglycaemia requiring oral or intravenous dextrose (lethargy, abnormal feeding behaviour or seizures). Results Fifteen of 106 babies developed hypoglycaemia within the first 24-h. Maternal and neonatal characteristics were not predictive. All babies with hypoglycaemia had an initial capillary BG ≤ 2.6 mmol/L (Area under the ROC curve (AUC) 0.96, 95% Confidence Interval (CI) 0.91–1.0). This result was validated on a further 65 babies, of whom 10 developed hypoglycaemia, in the first 24-h of life. Conclusion Using the 2.6 mmol/L threshold, extended monitoring as an inpatient could have been avoided for 60% of babies in this study. Whilst prospective validation is needed, this approach could help tailor postnatal care plans for babies born to mothers with GDM.

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P348 Do risk factors help to identify women from Africa with gestational diabetes mellitus?

International Journal of Gynecology & Obstetrics ◽

10.1016/s0020-7292(09)61839-7 ◽

2009 ◽

Vol 107 ◽

pp. S513-S514

Author(s):

H. Lombaard ◽

M. Mtsweni ◽

D. Van Zyl ◽

R. Pattinson

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus

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Risk factors for gestational diabetes mellitus among women screened with the two-step and one-step methods: A before-and-after study

Taiwanese Journal of Obstetrics and Gynecology ◽

10.1016/j.tjog.2018.08.010 ◽

2018 ◽

Vol 57 (5) ◽

pp. 668-671 ◽

Cited By ~ 3

Author(s):

Tai-Ho Hung ◽

Fu-Ling Chu ◽

T'sang-T'ang Hsieh

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Before And After ◽

One Step ◽

Before And After Study

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Heterogeneity of cardiovascular risk factors profile in non-diabetic women 2–24 months post gestational diabetes mellitus.

Gynecological Endocrinology ◽

10.3109/09513590.2013.831830 ◽

2014 ◽

Vol 30 (5) ◽

pp. 350-354 ◽

Cited By ~ 2

Author(s):

Alina Sokup ◽

Barbara Ruszkowska-Ciastek ◽

Małgorzata Walentowicz-Sadłecka

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Cardiovascular Risk ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Cardiovascular Risk Factors

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Study of Risk Factors for Conegnital Heart Defect in a Tertiary Level Hospital

Journal of Dhaka Medical College ◽

10.3329/jdmc.v27i1.38946 ◽

2018 ◽

Vol 27 (1) ◽

pp. 51-56

Author(s):

Ferdousi Hossain Poly ◽

Syeda Afroza ◽

Hasanur Rahman ◽

Md Imran Hassan

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Maternal Age ◽

Congenital Heart ◽

Heart Defects ◽

Medical College ◽

History Of ◽

The Difference

A congenital heart defect is a heart problem which is present at birth, caused by improper development of the heart during fetal development. In majority of cases there is no known reason for the heart to develop improperly. Some type of congenital heart defects are related to chromosomal abnormality(5-6%), some are to single gene defect(3-5%) or environmental factors(2%). In 85-90% of cases there is no identifiable cause and are generally considered to be caused by multifactorial inheritance. There are some maternal factors which have some role in cardiovascular malformations. These include high maternal age(above 30 years), maternal obesity, consanguinity among the parents, fever during pregnancy, gestational diabetes mellitus, smoking, alcohol consumption, ingestion of any teratogenic drug including homeopathy and herbal medicine. Objective of the study: To evaluate the risk factors associated with congenital heart disease. Methodology: A case control study was conducted at paediatric department of Sir Salimullah Medical College & Mitford Hospital following approval of the protocol from 1st January 2013 to 30th June 2014. Children fulfilling the inclusion criteria-(0-5 year old children of both sexes admitted in paediatric units of Mitford Hospital with any type of congenital heart disease confirmed by echocardiography) were considered as cases. A similar number of age and sex matched children admitted in Mitford Hospital without any cardiac defect were considered as controls. Data were collected by questionnaire. Results: The results show that majority of the cases are male. Maternal age (27.09 ± 4.63) and BMI (24.10 ± 2.28) both are significantly higher in cases than those of controls. Among the cases 31.8% mothers had consanguineous marriage (p=0.001) and 27.1% mothers had history of fever during pregnancy whereas it was present in 9.3% mothers of controls, the difference is significant statistically (p=0.001). Among the cases 34.6% mothers had history of gestational diabetes mellitus and only 18.9% controls had so and the difference is significant statistically (p=0.014). Conclusion: Relatively old age and more weight during pregnancy, consanguinity between parents, fever during pregnancy, history of gestational diabetes mellitus are the main risk factors of congenital heart defects in children J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 51-56

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Epigenetic Changes in Neonates Born to Mothers With Gestational Diabetes Mellitus May Be Associated With Neonatal Hypoglycaemia

Frontiers in Endocrinology ◽

10.3389/fendo.2021.690648 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yoshifumi Kasuga ◽

Tomoko Kawai ◽

Kei Miyakoshi ◽

Yoshifumi Saisho ◽

Masumi Tamagawa ◽

...

Keyword(s):

Diabetes Mellitus ◽

Dna Methylation ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Start Site ◽

Epigenetic Changes ◽

Neonatal Hypoglycaemia ◽

Transcription Start ◽

Cpg Sites ◽

Alternative Transcription

The detection of epigenetic changes associated with neonatal hypoglycaemia may reveal the pathophysiology and predict the onset of future diseases in offspring. We hypothesized that neonatal hypoglycaemia reflects the in utero environment associated with maternal gestational diabetes mellitus. The aim of this study was to identify epigenetic changes associated with neonatal hypoglycaemia. The association between DNA methylation using Infinium HumanMethylation EPIC BeadChip and neonatal plasma glucose (PG) level at 1 h after birth in 128 offspring born at term to mothers with well-controlled gestational diabetes mellitus was investigated by robust linear regression analysis. Cord blood DNA methylation at 12 CpG sites was significantly associated with PG at 1 h after birth after adding infant sex, delivery method, gestational day, and blood cell compositions as covariates to the regression model. DNA methylation at two CpG sites near an alternative transcription start site of ZNF696 was significantly associated with the PG level at 1 h following birth (false discovery rate-adjusted P < 0.05). Methylation levels at these sites increased as neonatal PG levels at 1 h after birth decreased. In conclusion, gestational diabetes mellitus is associated with DNA methylation changes at the alternative transcription start site of ZNF696 in cord blood cells. This is the first report of DNA methylation changes associated with neonatal PG at 1 h after birth.

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