The Significance of Hypoglycaemia in the Newborn Infant of the Diabetic Woman

Newborn infants of diabetic mothers commonly develop remarkably low concentrations of sugar in the blood within a few hours after birth. This has led many to believe that the high morbidity and mortality in these infants might be due to hypoglycaemia. The present study concerns 90 infants born to diabetic women. The frequent occurrence of hypoglycaemia in the newborn of diabetic mothers was confirmed. However, it was found that there was no relationship between the development of a morbid neonatal course and the concentration of sugar in the blood at time, or the extent and rapidity of the decrease in concentration. No correlation existed between the degree of hypoglycaemia and abnormal incidents in the first 2 weeks of life. The authors agree with the opinion held by most investigators, that there is no need to administer glucose to infants born of diabetic women. In these infants, oral administration of glucose is hazardous and administration of glucose solutions subcutaneously or intravenously only serves to increase the abnormal volume of body water, and may embarrass the heart. The authors advise that all fluid should be withheld from these infants until time fourth or fifth day of life. They found no evidence that the period of hypoglycaemia in the neonatal period was followed by subnormal intelligence in later childhood.

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Developmental Considerations in Working with Newborn Infants of Mothers with Diabetes

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.30.1.37 ◽

2011 ◽

Vol 30 (1) ◽

pp. 37-45

Author(s):

Margaret Quist Miller ◽

Lizbeth Ann Morris

Keyword(s):

At Risk ◽

Newborn Infant ◽

Clinical Reasoning ◽

Newborn Infants ◽

In Utero ◽

Behavioral Factors ◽

Reasoning Process ◽

Infants Of Diabetic Mothers ◽

Diabetic Mothers

AbstractInfants of diabetic mothers (IDMs) are at risk for an altered developmental course beginning with physiologic alterations in utero. This article describes physiologic and behavioral factors that impact the fetus and newborn infant and may have long-term developmental consequences. A clinical reasoning process to support development optimizes the outcomes of IDMs while in the NICU. Specific interventions are suggested.

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CHEMICAL HOMEOSTASIS IN THE NEWBORN INFANTS OF DIABETIC MOTHERS

PEDIATRICS ◽

10.1542/peds.13.6.527 ◽

1954 ◽

Vol 13 (6) ◽

pp. 527-535

Author(s):

GEORGE H. LOWREY ◽

BRUCE D. GRAHAM ◽

M. U. TSAO

Keyword(s):

Newborn Infant ◽

Newborn Infants ◽

High Plasma ◽

Infant Mortality Rate ◽

Electrolyte Balance ◽

Infants Of Diabetic Mothers ◽

Child Bearing ◽

Control Of Diabetes ◽

Total Base ◽

Diabetic Mothers

With the increased incidence of diabetic women reaching the child-bearing ages and their fertility being improved as a result of the use of insulin, there will be an increase in the number of newborn infants of diabetic mothers. Except for better control of diabetes in the mother there is no known method to reduce the infant mortality rate, which remains very high, approximately 30%. Likewise there is at present no completely adequate explanation for this poor prognosis. The present study of the blood electrolyte balance was undertaken to elucidate certain points in the physiology of the newborn infant of a diabetic mother. The 11 infants studied had extremely variable plasma chloride and total base levels and a high proportion of these had an uncompensated acidosis with a lowered blood pH when compared to the normal newborn infant. The high plasma CO2 tension indicates that ventilatory control of this factor was lacking, whether the fault be central or pulmonary. Furthermore, there appears to be a direct correlation between the degree of acidosis and the severity of the abnormal clinical picture present. The exact cause of this acidosis is not at present clear.

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Leptin Concentrations Are Elevated in Newborn Infants of Diabetic Mothers

Hormone Research in Paediatrics ◽

10.1159/000049993 ◽

2001 ◽

Vol 55 (4) ◽

pp. 185-190 ◽

Cited By ~ 24

Author(s):

Päivi Tapanainen ◽

Erja Leinonen ◽

Aimo Ruokonen ◽

Mikael Knip

Keyword(s):

Newborn Infants ◽

Infants Of Diabetic Mothers ◽

Diabetic Mothers

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Water and Electrolyte Economy in Newborn Infants of Diabetic Mothers

Acta Paediatrica ◽

10.1111/j.1651-2227.1960.tb07713.x ◽

1960 ◽

Vol 49 (2) ◽

pp. 121-128 ◽

Cited By ~ 5

Author(s):

CHARLES D. COOK ◽

DONOUGH O'BRIEN ◽

JOHN D. L. HANSEN ◽

MARC BEEM ◽

CLEMENT A. SMITH

Keyword(s):

Newborn Infants ◽

Infants Of Diabetic Mothers ◽

Diabetic Mothers

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Body Composition of Newborn Infants of Diabetic Mothers, Mogens Osler, Copenhagen F, Denmark, Osler, 1961, 79 pp

PEDIATRICS ◽

10.1542/peds.29.5.728 ◽

1962 ◽

Vol 29 (5) ◽

pp. 728-728

Author(s):

Marvin Cornblath

Keyword(s):

Body Composition ◽

Urinary Excretion ◽

Newborn Infants ◽

Body Water ◽

Review Of The Literature ◽

Infants Of Diabetic Mothers ◽

Proper Length ◽

Diabetic Mothers

Dr. Osler, in his monograph, merely reiterates and summarizes work he has done in studying the height, weight, urinary excretion, and compartmental body water in babies of diabetic mothers. In the monograph, he presents the data in a fashion that makes it impossible to analyze and has added nothing new except that the diabetic baby is the proper length for its weight. In addition, he has made a sketchy, uncritical review of the literature pertaining to these babies and presents the data, again, in a summary fashion.

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CHAPTER V: Pathogenetic aspects of some of the characteristic features in newborn infants of diabetic mothers

Acta Paediatrica ◽

10.1111/j.1651-2227.1965.tb15580.x ◽

1965 ◽

Vol 54 (s158) ◽

pp. 71-75

Keyword(s):

Newborn Infants ◽

Infants Of Diabetic Mothers ◽

Characteristic Features ◽

Diabetic Mothers

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Relative Rates of Fetal Hemoglobin and Adult Hemoglobin Synthesis in Cord Blood of Infants of Insulin-Dependent Diabetic Mothers

PEDIATRICS ◽

10.1542/peds.75.6.1143 ◽

1985 ◽

Vol 75 (6) ◽

pp. 1143-1147 ◽

Cited By ~ 2

Author(s):

Harry Bard ◽

Janie Prosmanne

Keyword(s):

Newborn Infants ◽

Methyl Cellulose ◽

Fetal Hemoglobin ◽

Acid Mixture ◽

Hemoglobin Synthesis ◽

Infants Of Diabetic Mothers ◽

Insulin Dependent ◽

Adult Hemoglobin ◽

Insulin Dependent Diabetic ◽

Diabetic Mothers

Erythrocytosis, extramedullary erythropoiesis, and increased levels of plasma erythropoietin have been observed in newborn infants of diabetic mothers. Because there is evidence that there is a relationship between increased fetal hemoglobin production and acute erythropoietic expansion, it was considered important to study the proportion of fetal hemoglobin and adult hemoglobin synthesis in newborn infants of insulin-dependent diabetic mothers. Samples from nine newborn infants of diabetic mothers as well as nine control infants, ranging from 36 to 38 weeks of gestation, were incubated in an amino acid mixture containing [14C]leucine. The adult hemoglobin and fetal hemoglobin were then separated by column chromatography on DEAE [O-(diethylaminoethyl)] Sephadex. To confirm that the fetal hemoglobin obtained after Sephadex chromatography was not contaminated with other hemoglobins, several of the DEAE separations from each group were reconstituted and subjected to polypeptide chain elution using carboxyl-methyl cellulose chromatography. The data demonstrated that the newborn infants of diabetic mothers are synthesizing significantly more fetal hemoglobin than is expected for their period of development (82.2 ± 3.6 v 72.8 ± 4.2; P < .005). It is suggested that the in utero environment of the fetus of the diabetic mother causes an increase in fetal hemoglobin synthesis.

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ALPHA1-FETOPROTEIN AND CARBONIC ANHYDRASE B AND C CONCENTRATION IN CORD BLOOD FROM NEWBORN INFANTS OF DIABETIC MOTHERS

Acta Endocrinologica ◽

10.1530/acta.0.075s081 ◽

1974 ◽

Vol 77 (3_Suppl) ◽

pp. S81-S86 ◽

Cited By ~ 4

Author(s):

B. Nørgaard-Pedersen ◽

J. G. Klebe

Keyword(s):

Carbonic Anhydrase ◽

Cord Blood ◽

Gestational Age ◽

Newborn Infants ◽

Infants Of Diabetic Mothers ◽

Carbonic Anhydrase B ◽

Erythrocyte Carbonic Anhydrase ◽

Diabetic Mothers

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.

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