A study of clinical, metabolic and hematological profile in infants of diabetic mothers.
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Date
2014-04
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Abstract
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.
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Keywords
Congenital malformations, Diabetes mellitus, Hypoglycemia, Neonate, Polycythemia
Citation
Gopal Girish. A study of clinical, metabolic and hematological profile in infants of diabetic mothers. Indian Journal of Pharmaceutical & Biological Research. 2014 Apr-Jun ; 2 (2): 34-40.