Acta Scientific Paediatrics (ISSN: 2581-883X)

Research Article Volume 3 Issue 3

A Prospective Study of the Neonatal Outcome in Diabetic Pregnancies

Lakshmi M, Anil H and Basavarajaiah DM*

Department of Paediatrics, Bangalore Medical College and Research Institute, Bengaluru, India

*Corresponding Author: Basavarajaiah DM, Department of Paediatrics, Bangalore Medical College and Research Institute, Bengaluru, India.

Received: January 28, 2020; Published: February 11, 2020

×

  India, being the second leading nation of diabetic subjects (69.2 million), has become the “Diabetic Capital of the World” harboring around 4 million women with GDM alone. IDF, 2013 has been estimated that, the total of 21.4 million live births will be affected with hyperglycemia in pregnancy. Though, the number of live births were affected by hyperglycemia in pregnancy, the rate has declined slightly from 21.4 million to 20.9 million in 2015, the adverse perinatal outcomes in (85.1%) cases are still due to GDM, (7.4%) due to other types of diabetes first diagnosed in pregnancy, and the remaining (7.5%) cases due to diabetes detected prior to pregnancy. Many challenges were pose to extrapolate the incidence of GDM at population level in global platform as well as national level and also which is cited by the less literature in Indian context, since more research should be inculcate to formulate the decision about the exposed population. In this intervene, the present study aims to know the occurrence of metabolic and haematological complications in infants of diabetic mothers and also correlate the occurrence of congenital anomalies in infants of diabetic mothers. It is a hospital based prospective cross sectional observational study, a total 100 neonates born to diabetic mothers were evaluated. The maternal history and details of glycemic control was recorded. Neonatal history, physical examination for the presence of major congenital anomalies and birth injuries was performed. Laboratory investigations like blood glucose, calcium, complete hemogram and echocardiography was done routinely in all babies. The results were compared and evaluated in both pregestational and gestational diabetes, the effect of glycemic control on the various neonatal complications were analyzed. The median age of diabetic mothers was 27 with SD 2.1 years. Gestational diabetes was seen in (74%) while pre gestational diabetes (26%). Hypoglycemia was the commonest metabolic complication documented (63%) cases, occurred within 6 hours of birth and polycythemia was the commonest hematological abnormality was seen in (45%) cases. Hypoglycemia was strongly associated with congenitalanomalies and macrosomia. Congenital anomalies were observed in (33%) cases where cardiac malformations were common of which ASD and PDA predominated. Birth injuries were seen in (11%) cases in which Erb’s palsy was seen in 6 cases and almost all injuries were due to macrosomia, which was seen in (34%) of all neonates born to diabetic mothers. There was a strong association of high levels of HbAIC levels with hypoglycemia, macrosomia and congenital malformations. Mortality in our study was 3% and all cases were died due to congenital anomaly. Women with pre gestational diabetes have an increased risk of congenital anomalies and mortality. This study also showed a high percentage of neonatal complications due to poor glycemic control in pregnancy. Hypoglycaemia in IDMs was strongly associated with congenital anomalies and macrosomia which was the major cause for morbidity and mortality in IDMs.

Keywords: Gestational Diabetes; Pregestational; HbA1C; Macrosomia; Hypoglycemia; Congenital Anomalies

×

References

  1. Dutta DC. “Diabetes mellitus in pregnancy”. In: Dutta DC. The text book of Obstetrics. 7th ed. New Delhi: New central book agency (2006): 281-287.
  2. WHO. Diabetes mellitus Fact sheet No. 138. WHO fact sheet No.138 Online (2002).
  3. Shah S., et al. “Diagnosis and management of Gestational Diabetes Mellitus”. Indian guidelines 3:78-79
  4. Havilah Polur K., et al. “Diabetes in Pregnancy Study Group in India (DIPSI)- A Novel Criterion to Diagnose GDM”. International Journal of Biochemistry Research and Review 10.1 (2016): 1-6.
  5. Carlo WA and Ambalavanan N. “The Endocrine system”. In: Kligeman RM, Stanton BF, Geme JW, Schor NF, editors. Nelson textbook of Pediatrics. New Delhi: Elsevier 1 (2015): 897-898. 
  6. Haider Shirazi., et al. “Neonatal Outcome of Diabetic Pregnancy”. Annals of Pakistan Institute of Medical Sciences 6.2 (2010): 107-112.
  7. Joanne Yang., et al. “Fetal and neonatal outcomes of diabetic pregnancies”. The Journal of Obstetrics and Gynecology 108.1 (2006): 644-650.
  8. Patt MJ., et al. “Outcome of diabetic pregnancies”. Diabetic Medicine 20 (2003): 82-83.
  9. Gillan Hawthorne., et al. “Prospective population based survey of outcome of pregnancies in diabetic women: result of Northern diabetic pregnancy Audit 1994”. BMJ 2 (1997): 279-281.
  10. Farooq MU., et al. Noor Specialist Hospital Makkah, Kingdom of Saudi Arabia Bahawal Victoria Hospital, Bahawalpur- Pakistan”. International Journal of Endocrinology Metabolism 3 (2007): 109-115. 
  11. Jeanne S., et al. “Maternal Diabetes Mellitus and Infant Malformations”. The American College of Obstetricians and Gynecologists 100.5 (2002): 655-659. 
  12. WHO World health day, India among top 3 countries with high diabetic population. Lancet study, annual report. 
  13. IDF - International Diabetes Federation. Annual Report (2016).
  14. Diabetes care. The Journal of Clinical and Applied Research and Education 39.1 (2016): 321-322.
  15. Williams obstetrics text book of obstetrics, 24th edition, New Delhi (2014): 2351-1388.
  16. Cloherty. Diabetes in pregnancy: In John p cloherty: manual of neonatal care, 7th edition (2016): 11-23.
  17. Avery’s. Diabetes in pregnancy: Avery’s diseases of the newborn, 9th edition (2012): 88-100. 
  18. Metzger BE., et al. “International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycemia in Pregnancy”. Diabetes Care 33 (2010): 676-682.
  19. Vandorsten JP., et al. “NIH consensus development conference: diagnosing gestational diabetes mellitus”. NIH State-of-the-Science Conference Statement 29 (2013): 1-31. 
  20. Sharma D., et al. “Asymmetrical septal hypertrophy and hypertrophic cardiomyopathy in infant of diabetic mother A reversible cardiomyopathy”. Medical Journal of Dr. D.Y. Patil Vidyapeeth 7.12 (2016): 257-260.
  21. Laura J., et al. “Cardiovascular disease risk in the offspring of diabetic women: the impact of the intrauterine environment”. Experimental Diabetes Research (2012). 
  22. N Freinkel. “Of pregnancy and progeny”. Diabetes 29.12 (1980): 1023-1035 
  23. Hod M., et al. “Prevalence of congenital anomalies and neonatal complications in the off springs of diabetic mothers in Israel”. Israel Journal of Medical Science 27.8 (1991): 498-502. 
  24. Ibrahim A., et al. “Perinatal morbidity and mortality in offspring of diabetic mothers in Qualif, Saudi Arabia”. European Journal of Obstetrics and Gynecology and Reproductive Biology 65 (1996): 165-169. 
  25. Diagnosis and classification of diabetes mellitus. American diabetes association. Diabetic care 29.1 (2006): 256-258.
  26. Shefali AK., et al. “Pregnancy outcomes in pre-gestational and gestational diabetic women in comparison to nondiabetic women--A prospective study in Asian Indian mothers (CURES-35)”. Journal of the Association of Physicians of India 54 (2006): 613-618.
  27. Aslam M., et al. “Clinical spectrum of infants of diabetic mothers in hospitalized deliveries at Lahore”. Pakistan Journal of Pathology 12.1 (2001): 5-8.
  28. White P. “Classification of obstetric diabetes”. American Journal of Obstetrics and Gynecology 130 (1978): 228-230. 
  29. Silva Idos S., et al. “Birthweight and other pregnancy outcome in a cohort of women with pre-gestational insulin-treated diabetes mellitus. Scotland”. Diabetic Medicine 95.22 (1979): 440-447.
  30. Schaefer-Graf UM., et al. “Patterns of congenital anomalies and relationship to initial maternal fasting glucose levels in pregnancies complicated by type 2 and gestational diabetes”. American Journal of Obstetrics and Gynecology 182 (2000): 313-320.
×

Citation

Citation: Basavarajaiah DM., et al. “A Prospective Study of the Neonatal Outcome in Diabetic Pregnancies”. Acta Scientific Paediatrics 3.3 (2020): 42-46.




Metrics

Acceptance rate33%
Acceptance to publication20-30 days
Impact Factor1.197

Indexed In




News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 30, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US