Three infants of diabetic mothers with malformations of left-right asymmetry???further evidence for the aetiological role of diabetes in this malformation spectrum

Abstract Background: Until now, diabetes during pregnancy has been associated with a high risk of maternal, fetal, and neonatal morbidities and mortalities. The main aim of this study was to evaluate the risk factors of hypoglycemia in infants of diabetic mothers (IDMs) and to study the relationship between umbilical cord (UC) C peptide levels and the risk of developing hypoglycemia.Material and methods: UC blood C-peptide and serial serum blood glucose measurements were done for all included singleton newborns born to diabetic mothers during the study period. Maternal and neonatal data such as gestational age, maternal age, maternal weight, types of diabetics and its control, maternal glycated hemoglobin (HbA1C), birth weight, Apgar score, and neonatal complete blood picture were collected.Results: In total, 83 IDMs met the inclusion criteria. Fifty-four (65.06%) developed hypoglycemia and 29 (34.94%) remained normoglycemic. However, there were no significant differences between hypoglycemic and normoglycemic IDMs in terms of types of maternal diabetics (P value = 0.41), its duration (P value= 0.43). The hypoglycemia peak occurred within the first 3 hours of life, with 33.11 ± 8.84 mg/dl for the hypoglycemia group and 54.10 ± 6.66 mg/dl for the normoglycemic group (P value < 0.0001). Most of the babies had no hypoglycemic manifestation (96.30%). Neonates with hypoglycemia their mothers had poor diabetes control in the last trimester (HbA1C 7.09 ± 0.96) compared to normoglycemic babies (HbA1C 6.11 ± 0.38), (P-value < 0.0001). The mean (SD) of UC C-peptide level in hypoglycemic neonates increased to 1.73 ± 1.07 ng/ml compared to normoglycemic ones with 1.08 ± 0.81 ng/ml (P value = 0.005).Conclusion: Poor diabetes control, especially in the last trimester, is associated with neonatal hypoglycemia. Increased UC C-peptide levels could be used as an early indicator for the risk of developing neonatal hypoglycemia and a predictor for babies need neonatal admission.

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Role of umbilical cord C-peptide levels in early prediction of hypoglycemia in infants of diabetic mothers

BMC Pediatrics ◽

10.1186/s12887-021-02547-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ahlam M. Saber ◽

Magdy A. Mohamed ◽

Abdelrahim A. Sadek ◽

Ramadan A. Mahmoud

Keyword(s):

Umbilical Cord ◽

Diabetes Control ◽

P Value ◽

Maternal Weight ◽

Neonatal Hypoglycemia ◽

C Peptide ◽

Infants Of Diabetic Mothers ◽

Serial Serum ◽

Diabetic Mothers

Abstract Background Until now, diabetes during pregnancy has been associated with a high risk of maternal, fetal, and neonatal morbidities and mortalities. The main aim of this study was to evaluate the risk factors of hypoglycemia in infants of diabetic mothers (IDMs) and to study the relationship between umbilical cord (UC) C peptide levels and the risk of developing hypoglycemia. Material and methods UC blood C-peptide and serial serum blood glucose measurements were done for all included singleton newborns born to diabetic mothers during the study period. Maternal and neonatal data such as gestational age, maternal age, maternal weight, types of diabetics and its control, maternal glycated hemoglobin (HbA1C), birth weight, Apgar score, and neonatal complete blood picture were collected. Results In total, 83 IDMs met the inclusion criteria. Fifty-four (65.06%) developed hypoglycemia and 29 (34.94%) remained normoglycemic. However, there were no significant differences between hypoglycemic and normoglycemic IDMs in terms of types of maternal diabetics (P value = 0.41), its duration (P value = 0.43). The hypoglycemia peak occurred within the first 3 h of life, with 33.11 ± 8.84 mg/dl for the hypoglycemia group and 54.10 ± 6.66 mg/dl for the normoglycemic group (P value < 0.0001). Most of the babies had no hypoglycemic manifestation (96.30%). Neonates with hypoglycemia their mothers had poor diabetes control in the last trimester (HbA1C 7.09 ± 0.96%) compared to normoglycemic babies (HbA1C 6.11 ± 0.38%), (P-value < 0.0001). The mean (SD) of UC C-peptide level in hypoglycemic neonates increased to 1.73 ± 1.07 ng/ml compared to normoglycemic ones with 1.08 ± 0.81 ng/ml (P value = 0.005). Conclusion Poor diabetes control, especially in the last trimester, is associated with neonatal hypoglycemia. Increased UC C-peptide levels could be used as an early indicator for the risk of developing neonatal hypoglycemia and a predictor for babies need neonatal admission.

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FAMILIAL DIABETES AND PERINATAL MORTALITY IN INFANTS OF DIABETIC MOTHERS

Acta Endocrinologica ◽

10.1530/acta.0.0370441 ◽

1961 ◽

Vol 37 (3) ◽

pp. 441-444

Author(s):

A. Nygaard ◽

M. Felbo ◽

J. Pedersen

Keyword(s):

Perinatal Mortality ◽

High Mortality ◽

Term Treatment ◽

Infants Of Diabetic Mothers ◽

Long Term Treatment ◽

Diabetic Mothers

ABSTRACT In a study of 173 pregnancies in 130 diabetic mothers of White's groups B, C and D who had received long-term treatment during pregnancy, the authors found cases of diabetes – in addition to the mother – in the maternal family, in the father and his family, or in the maternal as well as paternal family in a total of 100 pregnancies (57 %). The perinatal mortality was only slightly – and not significantly – higher among infants whose families included other diabetics than the mother. This higher mortality was found only among male infants of whom there was a preponderance in pregnancies with familial diabetes, but this was also not statistically significant. Thus, the result indirectly indicates that the primary cause of the high mortality among the infants of diabetic women must be the fact that the foetus develops in a diabetic environment.

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