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

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Citation

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

Copyright

Copyright: © 2020 Basavarajaiah DM., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.