Effect of maternal gestational diabetes mellitus on neonatal respiratory diseases in late-preterm infants / 中国新生儿科杂志

ABSTRACT

Objective To evaluate the effects of gestational diabetes mellitus (GDM) and its treatment during pregnancy on neonatal respiratory diseases in late-preterm infants.Method From January 2013 to December 2016,respiratory outcome of singleton infants (gestational age34-36 weeks) of GDM mothers(GDM group) was compared with infants delivered from mothers without GDM(non-GDM group).We also studied the relationship between maternal GDM treatment (insulin-treated GDM and diet-controlled GDM) and neonatal respiratory outcome,including incidences of respiratory diseases,mechical ventilation and oxygen supplementation.Result A total of 2 174 late-preterm infants were enrolled in this study,including 425 in GDM group and 1 749 non-GDM group.The average birth weight was (2 688 ± 423) g,ranging from 1 320 g to 4 275 g,and mean gestational age was (35.5 ± 0.7) weeks.Comparing with nonGDM group,the incidence of cesarean delivery was significantly higher in GDM group (35.5％ vs.30.5％,P ＜0.05),so was the incidence of antenatal corticosteroids (19.1％ vs.13.0％,P ＜0.01).GDM group was more likely to develop wet lung comparing with non-GDM group (8.0％ vs.5.4％,P ＜ 0.05).A similar incidence of neonatal respiratory distress syndrome (RDS),apnea,pneumonia,pneumothorax and pulmonary hypertension were found in the two groups (P ＞0.05).In the GDM group,a total of 91 infants were born to mothers with insulin-treated GDM and 334 diet-controlled GDM.Comparing with the diet controlled group,insulin treatment group was associated with higher risk of neonatal RDS (6.6％ vs.1.8％,P ＜ 0.05) and higher incidence of mechanical ventilation (13.2％ vs.6.0％,P ＜ 0.05).A similar incidences of wet lung,apnea,pneumonia,pneumothorax and pulmonary hypertension were found in the two groups (P ＞ 0.05).Conclusion The late-preterm infants born to GDM mothers with insulin treatment have higher incidences of neonatal RDS and mechanical ventilation,and they need much more care.