Clinical and metabolic profile of neonates of diabetic mothers

Abstract

Background:  Diabetes mellitus is the most common metabolic disorder complicating pregnancy. About 1-14% of all pregnancies are complicated by diabetes mellitus, 90% of them are Gestational Diabetes Mellitus (GDM). The present study was undertaken to describe clinical outcome & metabolic profile of neonates born to mothers with diabetes mellitus. Methods:  It was a hospital based prospective, non-randomized study conducted at department of paediatrics in G.B. pant hospital (neonatology section) an associated hospital of GMC Srinagar. The hospital is a referral tertiary care hospital of entire Kashmir valley. All infants born to diabetic mothers admitted at G.B. Pant hospital during the study period of one year (March 2011 to February 2012) were included in study. Results:  A total of 96 new-borns of diabetic mothers were included in study. 38 (40%) of these new-borns were large for gestational (LGA), 56 (58%) were Appropriate for Gestational Age (AGA) & two (2%) were Small for Gestational Age (SGA). Hypoglycemia was the leading morbidity & occurred in 34 (36%) of these new-borns. Hyperbilirubinemia (26 babies - 27%), Hypocalcemia (5 babies - 5%) & Hypomagnesemia (5 babies - 5%) were other morbidities present. Out of all babies respiratory distress syndrome occurred in 12 (13%), birth asphyxia in 10 babies (12%), polycythemia in 9(10%), congenital heart disease in 3 babies (3%) & other congenital malformations in 3 babies (3%), viz - myelomeningocele, tracheoesophageal fistula, cleft lip & palate respectively. All these morbidities were managed as per standard protocols outlined for these conditions. Out of these 96 study neonates death occurred in 1 neonate having congenital heart disease (mortality of ≈1/100 cases). Conclusions:  Infants born to diabetic mothers remain at high risk for development of clinical &metabolic complications. Optimal care of these infants is based on prevention, anticipation, early recognition & treatment of these conditions.