Gestational Diabetes and Perinatal Outcomes: 5-Year Neonatal Intensive Care Experience

Abstract

Aim: In this study, we examined clinical and laboratory findings of mothers diagnosed with Gestational diabetes mellitus (GDM) and their babies, as well as problems emerging during the perinatal period, maternal demographics, and the interrelation between these features. Materials and methods: In the present study, we retrospectively evaluated 180 babies who were born to mothers diagnosed with GDM, and admitted to neonatal intensive care unit (NICU) of our hospital between July 31, 2012 and July 31, 2017. Results: Totally 3263 patients were admitted to NICU between July 31, 2012 and July 31, 2017. Among these, 180 (5.5%) were born to mothers with GDM. Of these babies, 119 (66.1%) were male, and 61 (33.9%) were female. 151 (83.8%) were term-infants, while 29 (16.2%) were preterm infants. Mean birth weight was 3245±693 (1000gr - 5010gr), the mean hospital stay length was 8,6±1,4 days, and the mean 5th minute Apgar score was 8.7±1.9. 43 (23.8%) babies were large for gestational age (LGA), and macrosomia was detected in 16 (8.8%) infants. Mean maternal age was 31±5.4 years, and the mean number of pregnancies was 2.3±1.1. During their pregnancy, 12 mothers (6.6%) had hypothyroidism, 10 (5.5%) had urinary tract infection, 6 (3.3%) had gestational hypertension, 5 (2.7%) had asthma, 4 (2.2%) had oligohydramniosis, 3 (1.6%) had influenza infection, 3 (1.6 %) had premature rupture of membranes (PROM), 2 (1.1%) had polyhydramniosis, and 1 (0.5%) had hyperthyroidism. A total of 38 (21.1 %) mothers had 25 (OH) vitamin D deficiency and 25(OH) deficiency was severe in 18 of them. The most common metabolic disorder was hypocalcemia, which was observed in 49 (27,2%) patients. A total of 42 (23,3%) infants had 25 (OH) vitamin D deficiency, and 25 (OH) vitamin D deficiency was severe in 18 infants. Conclusion: GDM is a metabolic disorder requiring close monitoring and the rate of fetal loss and morbidity is 2-4 times higher compared to normal pregnancies. In addition to the associated increase in the risk of GDM, vitamin D deficiency also poses risk for the newborn. Therefore, in addition to metabolic monitoring, we think assessment of vitamin D status prior to pregnancy is necessary, because treatment of vitamin deficiency may help to reduce morbidity.