scholarly journals Metabolic and Haematological Profile of Infants Born to Gestational and Pregestational Diabetic Mothers

2020 ◽  
Vol 44 (2) ◽  
pp. 82-86
Author(s):  
Sheikh Farjana Sonia ◽  
Md Fazlul Haque ◽  
Ruma Parvin ◽  
Azmeri Sultana ◽  
Sharmin Afroze ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Age ◽  
Neonatal Period ◽  
Large For Gestational Age ◽  
P Value ◽  
Haematological Parameter ◽  
Blood Samples ◽  
Haematological Profile ◽  
Appropriate For Gestational Age ◽  
Diabetic Mothers

Background: Diabetes mellitus is the most common metabolic disorder complicating pregnancy. Infants of diabetic mothers (IDMs) are prone to develop complications during early neonatal period. The study was undertaken to describe and compare the metabolic and haematological parameter of infants born to gestational (GDM) and pregestational (PGDM) diabetic mothers. Meterials and Methods: The hospital based prospective study was conducted at special care neonatology unit of Dr. M. R. Khan Shishu Hospital & ICH from January 2018 to December 2018. Blood samples were collected to perform relevant biochemical and haematological tests. Results: Of the 68 neonates, 61.8% were born to mothers with GDM and 38.2% were born to mothers with PGDM. In case of GDM, 4.8% were Small for Gestational Age (SGA), 61.9% were Appropriate for Gestational Age (AGA) and 33.3% were Large for Gestational Age (LGA). Hypoglycemia occurred in 71.4% of neonates with GDM and 53.8% of neonates with PGDM. Hypocalcemia was observed in 47.6% of neonates with GDM and 69.2% of neonates with PGDM. Frequency of hypoglycemia, polycythemia and hyperbilirubinemia were significantly higher in neonates born to mothers with GDM (p value 0.01, 0.02 and < 0.001 respectively) and frequency of hypocalcemia was significantly higher in neonates born to mothers with PGDM (p value 0.02). Conclusions: The frequency of hypoglycaemia, polycythemia and hyperbilirubinemia were significantly more in newborns of GDM compared to infants of PGDM but the frequency of hypocalcemia was significantly more in newborns of PGDM. Bangladesh J Child Health 2020; VOL 44 (2) :82-86

scholarly journals Frequency of Neonatal Hypoglycemia in Large for Gestational Age Infants of Non-Diabetic Mothers in a Community Maternity Hospital

2006 ◽  
Vol 49 (4) ◽  
pp. 237-239 ◽  
Author(s):  
Nilgun Araz ◽  
Mustafa Araz
Keyword(s):  
Blood Glucose ◽  
Gestational Age ◽  
Maternity Hospital ◽  
Large For Gestational Age ◽  
Control Group ◽  
Neonatal Hypoglycemia ◽  
Glucose Levels ◽  
Increased Risk ◽  
Appropriate For Gestational Age ◽  
Diabetic Mothers

Large for gestational age (LGA) infants are at increased risk for hypoglycemia. The aim of the study was to determine the frequency of neonatal hypoglycemia in LGA infants of non-diabetic mothers in a Community Maternity Hospital in Gaziantep, Turkey. Hospital records of 5229 infants of non-diabetic mothers were examined retrospectively. Newborns with birth weight more than 4000 g were defined as LGA. The control group consisted of 100 appropriate for gestational age (AGA) newborns. Capillary blood glucose was measured at the second hour of life. Glucose values lower than 40 mg/dL (2.2 mmol/L) were defined as hypoglycemia. Ninety-six (1.8%) of the 5229 infants were found to be LGA. The mean capillary glucose levels of the LGA newborns were significantly lower than those of the AGA newborns (54 mg/dL (3.0 mmol/L) vs. 95 mg/dL (5.2 mmol/L), p<0.0001). Neonatal hypoglycemia was established in 16 of 96 LGA infants (16.7%). In the control group hypoglycemia was absent. The rate of hypoglycemia in LGA infants was significantly higher than the rate in the AGA infants (p=0.0000). As hypoglycemia is not rare in LGA infants and can have serious consequences, blood glucose levels should be screened routinely in LGA infants.

Macrosomia in Infants of Insulin-Dependent Diabetic Mothers

PEDIATRICS ◽  
1989 ◽  
Vol 83 (6) ◽  
pp. 1029-1034
Author(s):  
Michael A. Berk ◽  
Francis Mimouni ◽  
Menachem Miodovnik ◽  
Vicki Hertzberg ◽  
Jennifer Valuck
Keyword(s):  
Glycemic Control ◽  
Gestational Age ◽  
Perinatal Outcomes ◽  
Large For Gestational Age ◽  
Third Trimester ◽  
The Third ◽  
Appropriate For Gestational Age ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic ◽  
Diabetic Mothers

The purpose of the present study was to evaluate factors affecting the rate of macrosomia and related complications in a population of infants of insulin-dependent diabetic mothers. The following factors were hypothesized to be predisposing to macrosomia: increased maternal weight gain during gestation, increased number of births until infant No. 3, white race, increased maternal age, poor glycemic control from the 20th week of gestation, and increased insulin dose. Advance White classification and increased duration of diabetes were predicted to be inversely related. In addition, macrosomia was hypothesized to predispose to selected adverse perinatal outcomes including premature labor, birth asphyxia, birth injury, hypoglycemia, polycythemia, and respiratory distress syndrome. From 1978 to 1986, 127 pregnancies were prospectively studied, 86 of the total number of women were entered prior to 10 weeks' gestation, and 41 were entered after 10 weeks' gestation. Patients monitored blood glucose at least twice daily with glycemic control achieved by "split-dosage" regimens of insulin. Glycohemoglobin was measured monthly. Pregnancy dating was based on the date of the last menstrual period and the Ballard score of the infant at birth. Macrosomia was defined as a birth weight greater than the 90th percentile of the intrauterine growth curves of Lubchenco. Of the babies born to mothers with insulin-dependent diabetes, 43% were large for gestational age and 57% were appropriate for gestational age. Maternal factors predisposing to an infant being large for gestational age included glycohemoglobin measurement at the time of delivery (large for gestational age = 8.4% ± 0.3%, appropriate for gestational age = 7.6% ± 0.2%, P &lt; .05, normal = 5.5% to 8.5%), reflecting poorer glycemic control during the third trimester, weight gain in the third trimester, and advanced White classification by univariate analysis compared to mothers of babies with birth weights appropriate for gestational age. However, only glycohemoglobin at the time of delivery was significant when these variables were subjected to multiple logistical regression. Macrosomic infants had higher rates of both polycythemia (large for gestational age = 23.6%, appropriate for gestational age = 6.9%, P &lt; .008) and hyperbilirubinemia (large for gestational age = 29.6%, appropriate for gestational age = 12.7%, P &lt; .02) than nonmacrosomic infants but did not differ in other perinatal outcomes. The data suggest that, in spite of improvements in glycemic control in the recent past, macrosomia still exists at an increased rate in infants of diabetic mothers and is significantly related to poorer glycemic control in the third trimester. In addition, large for gestational age infants are at an increased risk for both polycythemia and hyperbilirubinemia.

Hyperbilirubinemia in Infants of Diabetic Mothers

PEDIATRICS ◽  
1980 ◽  
Vol 66 (3) ◽  
pp. 417-419
Author(s):  
Keith J. Peevy ◽  
Stephen A. Landaw ◽  
Steven J. Gross
Keyword(s):  
Gestational Age ◽  
Serum Bilirubin ◽  
Mode Of Delivery ◽  
Hemoglobin Concentration ◽  
Large For Gestational Age ◽  
Increased Risk ◽  
Appropriate For Gestational Age ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic ◽  
Diabetic Mothers

Large for gestational age (LGA) infants of insulin-dependent diabetic mothers (IDM), appropriate for gestational age (AGA) IDM, and infants of nondiabetic mothers were compared for the incidence of neonatal hyperbilirubinemia and related etiologic factors. At 60 hours of age, LGA IDM had significantly higher serum bilirubin concentrations (12.3 ± 2.1 mg/100 ml) than AGA IDM (7.6 ± 3.9 mg/100 ml) or control infants (7.8 ± 2.8 mg/100 ml) (P &lt; .001). Peak serum bilirubin concentrations were also significantly higher in LGA IDM (14.4 ± 2.1 mg/100 ml) than in AGA IDM (8.4 ± 3.7 mg/100 ml) or control infants (8.6 ± 3.3 mg/100 ml) (P &lt; .001). Mean percent of carboxyhemoglobin was used as an indicator of hemolysis and showed a significant elevation in LGA IDM (1.51 ± 0.19) when compared to AGA IDM (1.10 ± 0.27) and control infants (1.19 ± 0.33) (P &lt; .05). No significant differences were found among the three groups with respect to mode of delivery, frequency of pitocin administration, 5-minute Apgar scores, incidence of isoimmunization, incidence of enclosed hemorrhage, hemoglobin concentration, bilirubin concentrations at 12 hours, and percent of weight loss. Our data suggest that only LGA IDM are at increased risk for hyperbilirubinemia and that increased heme turnover is a significant factor in the pathogenesis.

scholarly journals A study of clinical, metabolic and hematological profile in infants of diabetic mothers

2014 ◽  
Vol 2 (02) ◽  
pp. 34-40 ◽  
Author(s):  
Girish Gopal
Keyword(s):  
Diabetes Mellitus ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Birth Weight ◽  
Gestational Age ◽  
Congenital Anomalies ◽  
Congenital Heart ◽  
Neonatal Period ◽  
Infants Of Diabetic Mothers ◽  
Diabetic Mothers

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.

scholarly journals Perinatal Asphyxia Among Neonates Admitted Jimma Medical Center, Jimma, Ethiopia

2020 ◽  
Vol 7 ◽  
pp. 2333794X2098130
Author(s):  
Ebissa Bayana Kebede ◽  
Adugna Olani Akuma ◽  
Yonas Biratu Tarfa
Keyword(s):  
Gestational Age ◽  
Medical Center ◽  
Perinatal Asphyxia ◽  
Mode Of Delivery ◽  
Large For Gestational Age ◽  
Systematic Sampling ◽  
P Value ◽  
Health Extension Workers ◽  
Severe Problem ◽  
Prolonged Labor

Background: Perinatal asphyxia is a severe problem which causes serious problem in neonates in developing countries. This study is aimed to determine magnitude of perinatal asphyxia and its associated factors. Methods: A cross-sectional study design was conducted among neonates admitted over a period of 4 years on 740 samples. Systematic sampling method was employed to get required samples from log book. Epi-data 3.1 is used for data entry and the entered data was exported to SPSS Version 23 for analysis. Bivariable and multiple variable logistic regressions analysis were applied to see the association between dependent and independent variables. Finally, P-value <.05 at 95% CI was declared statistically significant. Results: The main significant factor associated to perinatal asphyxia were prolonged labor ( P = .04, AOR = 1.68 95%CI: [1.00, 2.80]), being primipara ( P = .003, AOR = 2.06, 95%CI: [1.28, 3.30]), Small for Gestational Age (SGA) ( P = .001, AOR = 4.35, 95%CI: [1.85, 10.19]), Large for Gestational Age ( P = .001, AOR = 16.75, 95%CI: [3.82, 73.33]) and mode of delivery. Conclusion: The magnitude of perinatal asphyxia was 18%. Prolonged labor, parity, birth size, mode of delivery, and APGAR score at 1st minute were significantly associated with perinatal asphyxia. So, Nurses, Midwives, Medical Doctors, and health extension workers have to engage and contribute to on how to decrease the magnitude of perinatal asphyxia.

Leptin, Insulin, and Glucose Serum Levels in Large-for-Gestational-Age Infants of Diabetic and Non-Diabetic Mothers

2008 ◽  
Vol 21 (1) ◽  
Author(s):  
M.M. Vela-Huerta ◽  
E.U. San Vicente-Santoscoy ◽  
J.M. Guizar-Mendoza ◽  
N. Amador-Lieona ◽  
C. Aldana-Valenzuela ◽  
...  
Keyword(s):  
Gestational Age ◽  
Serum Levels ◽  
Large For Gestational Age ◽  
Diabetic Mothers

scholarly journals Comparison of neonatal outcomes of small for gestational age and appropriate for gestational age preterm infants born at 28–36 weeks of gestation: a multicentre study in Ethiopia

2020 ◽  
Vol 4 (1) ◽  
pp. e000740
Author(s):  
Netsanet Workneh Gidi ◽  
Robert L Goldenberg ◽  
Assaye K Nigussie ◽  
Elizabeth McClure ◽  
Amha Mekasha ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Late Onset ◽  
Early Recognition ◽  
Neonatal Outcomes ◽  
P Value ◽  
Prolonged Hospitalisation ◽  
Increased Risk ◽  
Appropriate For Gestational Age

PurposeThe aim of this study was to assess morbidity and mortality pattern of small for gestational age (SGA) preterm infants in comparison to appropriate for gestational age (AGA) preterm infants of similar gestational age.MethodWe compared neonatal outcomes of 1336, 1:1 matched, singleton SGA and AGA preterm infants based on their gestational age using data from the study ‘Causes of Illness and Death of Preterm Infants in Ethiopia (SIP)’. Data were analysed using SPSS V.23. ORs and 95% CIs and χ2 tests were done, p value of <0.05 was considered statistically significant.ResultThe majority of the infants (1194, 89%) were moderate to late preterm (32–36 weeks of gestation), 763 (57%) were females. Male preterm infants had higher risk of being SGA than female infants (p<0.001). SGA infants had increased risk of hypoglycaemic (OR and 95% CI 1.6 (1.2 to 2.0), necrotising enterocolitis (NEC) 2.3 (1.2 to 4.1), polycythaemia 3.0 (1.6 to 5.4), late-onset neonatal sepsis (LOS) 3.6 (1.1 to 10.9)) and prolonged hospitalisation 2.9 (2.0 to 4.2). The rates of respiratory distress syndrome (RDS), apnoea and mortality were similar in the SGA and AGA groups.ConclusionNeonatal complications such as hypoglycaemic, NEC, LOS, polycythaemia and prolonged hospitalisation are more common in SGA infants, while rates of RDS and mortality are similar in SGA and AGA groups. Early recognition of SGA status, high index of suspicion and screening for complications associated and timely intervention to prevent complications need due consideration.

125I-human epidermal growth factor specific binding to placentas and fetal membranes from various pregnancy states

1988 ◽  
Vol 117 (4) ◽  
pp. 485-490 ◽  
Author(s):  
Glen E. Hofmann ◽  
Ch. V. Rao ◽  
Fred R. Carman ◽  
Tariq A. Siddiqi
Keyword(s):  
Gestational Age ◽  
Specific Binding ◽  
Large For Gestational Age ◽  
Fetal Membrane ◽  
Fetal Membranes ◽  
Intrauterine Growth ◽  
Class A ◽  
Appropriate For Gestational Age ◽  
Epidermal Growth ◽  
Twin Pregnancies

Abstract. Specific binding of 125I-human epidermal growth factor (hEGF) to homogenates of term human placentas and fetal membranes from normal and appropriate for gestational age (N = 20), intrauterine growth retarded (N = 9), twin (N = 11), White class A/B diabetic (N = 12), and large for gestational age (N = 13) pregnancies was measured. In all pregnancy states, placentas bound approximately four times more 125I-hEGF than did fetal membranes (P < 0.001). There was no significant difference in 125I-hEGF binding to fetal membranes from the various pregnancy states (P > 0.05). 125I-hEGF specific binding to placentas from intrauterine growth retarded or twin pregnancies was significantly greater compared with placentas from normal and appropriate for gestational age pregnancies (P < 0.05). The binding to placentas from pregnancies complicated by White class A/B diabetes or large for gestational age infants, on the other hand, was not significantly different from that to placentas from normal and appropriate for gestational age pregnancies. 125I-hEGF specific binding did not differ between placentas from intrauterine growth retarded or twin pregnancies (P > 0.05). Placental and fetal membrane 125I-hEGF binding did not vary with fetal sex, maternal race, placental weight, or gestational age between 37 to 42 weeks (P > 0.05). Placental but not fetal membrane 125I-hEGF binding increased with increasing infant weight when appropriate for gestational age and large for gestational age infants were included (P < 0.05, r = 0.38, N = 32) but not for intrauterine growth retarded, appropriate for gestational age, or large for gestational age infants alone.

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