scholarly journals Neonatal Morbidity Pattern among Infants Born to Diabetic Mothers at Jamhouria Hospital, Benghazi- Libya

2021 ◽  
pp. 38-55
Author(s):  
Munera Awad Radwan ◽  
Najia Abdelati El Mansori ◽  
Mufeda Ali Elfergani ◽  
Faiaz Ragab Halies ◽  
Mohanad Abdulhadi Lawgali
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Glycemic Control ◽  
Gestational Diabetes ◽  
Congenital Anomalies ◽  
Maternal Diabetes ◽  
Birth Trauma ◽  
Metabolic Disturbance ◽  
Cardiac Lesion ◽  
Diabetic Mothers

Introduction: Diabetes has long been associated with maternal and perinatal morbidity and mortality. The infant of a diabetic mother have higher risks for serious problems during pregnancy and at birth. Problems during pregnancy may include increased risks of abortions and stillbirths. Abnormal fetal metabolism during pregnancy complicated by maternal diabetes mellitus results in multiple neonatal sequallae, including abnormalities of growth, glucose and calcium metabolism, hematologic status, cardio- respiratory function, bilirubin metabolism, and congenital anomalies. The causes of the fetal and neonatal sequallae of maternal diabetes are Multifactorial. However, many of the perinatal complications can be traced to the effect of maternal glycemic control on the fetus & can be prevented by appropriate periconceptional & prenatal care. Objective:  to describe the morbidity pattern among infants of diabetic mothers (IDMs) either gestational or preconception diabetes mellitus. Methods:  A cross sectional study was conducted in Jamhouria hospital/ neonatal ward & enrolled 120 consecutive infants born to diabetics mother either gestational or preconception diabetes mellitus over one year period. Results: 120 babies were diagnosed as IDMs and were admitted to Neonatal intensive care unit, male, female, 74(60.8%) were gestational diabetes, and 46 (38.3%) with preconception diabetes, full term comprise 98 cases (81.6%) while premature were 22 cases (18.3%). For birth weight 20 case [16.7%} were low birth weight, macrosomia represent 16 case (13.3%). Most common congenital anomalies was cardiac lesion 36 cases, for GDM 18 case =24.3% were PCDM 18 case around 40.0%. Central nervous system 11 case (9.1%) all of them dilated ventricular system& only 2 of them need surgical intervention with shunt. Gastrointestinal anomalies 4 cases {3.4%} 2 of them ectopic anus & 2 short bowel syndrome. Most common metabolic disturbance was Hypocalcemia 17 case (14.1%), followed by hypoglycemia 11 case (9.1%), followed with hyper bilirubinemia 3 cases (2.5%) Followed by Respiratory distress syndrome 26 case (21.6%), 17 case hyaline membrane disease (14.1%) ,transient tachypnea of neo born 9 cases (7.5%) , Birth trauma  3 cases Erb,s palsy one of them  birth asphyxia. Conclusion: Most common type of diabetes in pregnancy is gestational diabetes, and most common congenital anomalies is the cardiac lesion & the most common metabolic disturbance is the hypocalcemia. Macrosomia associated with large birth weight as well as birth trauma. Large for gestational age and hypoglycemia associated mainly with poor maternal glycemic control.

scholarly journals Gestational Diabetes Mellitus: Impact of Maternal Blood Sugar Level and BMI on Foetal Birth Weight

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Dr. Bipul Prasad Deka ◽  
Dr. Dimpy Begum
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Fasting Blood Glucose ◽  
Maternal Blood ◽  
Overweight And Obesity ◽  
Medical College ◽  
Control Study ◽  
Diabetic Mothers

Gestational diabetes mellitus (GDM) is defined as glucose intolerance of variable degrees with an onset, or first recognized, during pregnancy. About 15-45% of babies born to diabetic mothers can have macrosomia. This prospective case control study was conducted in the department of Obstetrics and Gynaecology of Gauhati medical college and hospital, Guwahati, Assam during the period of 2013-2015. A total of 160 patients were included in the study. 100 patients without any glucose abnormality were taken as control and 60 patients with gestational diabetes mellitus were included in the study as cases. In this study it was found that mean birth weight in GDM cases is more than normoglycemic control. The overweight and obesity group (BMI>25) have maximum birth weight. In this study it was found that the fasting blood glucose level is maximum in mothers with baby birth weight >3.5 kg.

scholarly journals Oral Hypoglycemic Glibenclamide: Can it be a Substitute to Insulin in the Management of Gestational Diabetes Mellitus? A Comparative Study

2012 ◽  
Vol 4 (1) ◽  
pp. 28-31 ◽  
Author(s):  
Partha Mukhopadhyay ◽  
Tara Sankar Bag ◽  
Amit Kyal ◽  
Dipta Prasun Saha ◽  
Noori Khalid
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Birth Weight ◽  
Glycemic Control ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Comparative Study ◽  
Blood Sugar ◽  
Group A ◽  
Group B

ABSTRACT Introduction Gestational diabetes is a common medical disorder in pregnancy. So long, it has been usually treated by insulin. Now it has been found that oral glibenclamide can be used instead of insulin with similar glycemic control and without any adverse maternal and fetal effect. Methods A comparative study between oral glibenclamide and insulin for the management of gestational diabetes mellitus (GDM) was conducted. It was a prospective randomized study and patients attending the antenatal clinic were screened with 75 gm oral glucose between 20 to 28 weeks and GDM was diagnosed based on WHO criteria of 2 hours blood glucose ≥140 mg/dl. Women with gestational diabetes were given medical nutritional therapy (MNT) for 2 weeks. Out of this, 60 women did not achieve the target blood glucose. The goal of treatment was maintenance of mean plasma glucose (MPG) of about 105 mg%. For this the fasting plasma glucose should be around 90 mg/dl and postprandial peaks around 120 mg/dl. Patients were randomly assigned to receive glibenclamide (group A, n = 30) or insulin (group B, n = 30). In group A, glibenclamide was given 2.5 mg orally in morning and doses were increased weekly by 2.5 mg up to a maximum of 20 mg and doses >7.5 mg were given in two divided doses. In group B, insulin 0.7 units per kilogram of body weight at admission was given subcutaneously three times daily and increased weekly as necessary. Self monitoring of blood glucose with glucometer was done. Blood glucose was also measured from the laboratory every week. Glycosylated hemoglobin (HbA1c) was measured before initiation of therapy and repeated in the third trimester before confinement. Terminations of pregnancy in both the groups were done between 37 and 38 weeks. The infant birth weight, blood glucose and serum bilirubin were also recorded in all cases. Results The present study showed that the two groups had similar glycemic status (fasting blood sugar in group A was 103.5 ± 14.62 mg/dl and postprandial blood sugar was 184.1 ± 20.46 mg/dl whereas in group B it was109.3 ± 19.63 mg/dl and 194.3 ± 18.47mg/dl) at the time of entry into the study. The two groups also showed similar levels of glycemic control just before confinement (fasting blood sugar in group A was 88.23 ± 6.55 mg/ dl and postprandial blood sugar was 122.7 ± 10.3 mg/dl whereas in group B it was 88.17 ± mg/dl and 128 ± 12.38 mg/dl) and there was no significant statistical difference in the two groups (p > 0.05). The perinatal outcomes in both the groups were also nearly same. There was no significant difference in birth weight, blood sugar level of neonates and complications between the two groups. There was no case of macrosomia in the two groups and the number of infants large for gestational age (LGA) was four in group A and two in group B. Hypoglycemia in newborn was slightly higher in the group A compared to group B (4 and 3 respectively). Conclusion From our study, it is evident that the use of oral agents is a pragmatic alternative to insulin therapy in cases of gestational diabetes because of similar glycemic control, ease of administration and better patient compliance due to noninvasive treatment. How to cite this article Mukhopadhyay P, Bag TS, Kyal A, Saha DP, Khalid N. Oral Hypoglycemic Glibenclamide: Can it be a Substitute to Insulin in the Management of Gestational Diabetes Mellitus? A Comparative Study. J South Asian Feder Obst Gynae 2012;4(1):28-31.

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.

Gestational diabetes mellitus: Glycemic control during pregnancy and neonatal outcomes of twin and singleton pregnancies

2018 ◽  
Vol 65 (6) ◽  
pp. 319-327
Author(s):  
María Augusta Guillén-Sacoto ◽  
Beatriz Barquiel ◽  
Natalia Hillman ◽  
María Ángeles Burgos ◽  
Lucrecia Herranz
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Neonatal Outcomes ◽  
Singleton Pregnancies

scholarly journals Maternal Diabetes Mellitus as a Risk Factor for High Blood Pressure in Late Childhood

Hypertension ◽  
2019 ◽  
Vol 73 (1) ◽  
Author(s):  
Joana Oliveira Miranda ◽  
Rui João Cerqueira ◽  
Henrique Barros ◽  
José Carlos Areias
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Body Mass ◽  
Cardiovascular Effects ◽  
Maternal Diabetes ◽  
Diabetes Mellitus Group ◽  
The Impact ◽  
Maternal Diabetes Mellitus ◽  
Diabetic Mothers

Intrauterine fetal conditions can have lifelong cardiovascular effects. The impact of maternal diabetes mellitus on children’s cardiovascular profile is not well established. The goal of this study was to explore the association between maternal diabetes mellitus and offspring’s blood pressure (BP) ≤10 years of age. Generation XXI is a prospective birth cohort, which enrolled 8301 mother-offspring pairs, including 586 (7.1%) children of diabetic mothers. The associations between maternal diabetes mellitus and BP at 4, 7, and 10 years of age was modeled using linear regression. A mixed-effects model was built to assess differences in BP variation over time. Path analysis was used to quantify effects of potential mediators. Maternal diabetes mellitus was associated with higher BP in offspring at the age of 10 (systolic: β, 1.48; 95% CI, 0.36–2.59; and diastolic: β, 0.86; 95% CI, 0.05–1.71). This association was independent of maternal perinatal characteristics, and it was mediated by child’s body mass index and, to a lesser extent, by gestational age, type of birth, and birth weight (indirect effect proportion, 73%). No significant differences in BP were found at 4 and 7 years of age. Longitudinal analysis showed an accelerated systolic BP increase on maternal diabetes mellitus group (β, 1.16; 95% CI, 0.03–2.28). These finding were especially relevant in males, suggesting sex differences in the mechanisms of BP prenatal programing. Our results provide further evidence that maternal diabetes mellitus is associated with high BP late in childhood, demonstrating a significant role of child’s body mass in the pathway of this association.

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