Comparison of morbidities between infants of pregestional and gestational diabetic monthers

ABSTRACT

To describe and compare the clinical outcome of infants born to mothers with gestational and pregestational diabetes mellitus, this study was conducted between January 2000 to January 2002 in Tehran Vali -E-Asr Hospital. Among 4472 deliveries, we found 107 infants born to diabetic mothers out of whom 6 were twins. The prevalence of diabetes in total deliveries was 2.39%. Mean age of gestational and pregesstational diabetic mothers was 30.9 +/- 5.86 and 31 +/- 5.37 respectively. 74 infants [69%] belonged to gestational diabetic mothers. 50% of infants were males. Mean birth weight of infants was 3067 +/- 784.917 [700-5600g]. Gestational age in 57% of was less than 38 weeks. APGAR score at 1 and 5 minutes was <6 in 10 and 5 cases respectively. Hypoglycemia was detected in 31%, hypocalcemia in 13%, hypomagnesemia in 4.5%, polycythemia in 6.8%, macrosomia in 28.6%, small for gestational age in 2%, respiratory distress syndrome in 8.2%, early sepsis in 9.2%, NICU admission in 23.7%, and hyperbilirubinemia in 34%. The incidences of most of these morbidities were higher in infants of pregestational diabetic mothers. The differences between the incidence of hypoglycemia, hypocalcemia and 5 minute APGAR score in infants of pregestational and gestational diabetic mothers were significant [p<0.05]. There was a significant correlation between the incidence of hypoglycemia and birth weight of infants [p<0.05]. The existence of congenital anomalies in infants of gestational diabetic mothers could be due to unrecognized cases of noninsulin dependent diabetes mellitus, and with respect to mean age of mothers it is advisable to detect diabetes before pregnancy in high risk groups and correct the level of hemoglobin A [1c] before pregnancy. Cleft palate and undescended testes among the anomalies support this hypothesis that prostaglandin deficiency may have a role in the pathophysiology of congenital malformations in these infants