Biochemical and Physiological Characteristics of Neonates Born to Mothers with Diabetes During Gestation

Abstract

Summary:The aim of this study was to investigate how glucose homeostasis disorders influence biochemical homeostasis and fetal maturation. A prospective ran domized study included 102 infants: 31 new borns of mothers with glucose homeostasis disorders (Group I) and 71 newborns of healthy mothers (Group II). In the preg nant women, the mean age, body weight and height, BMI, parity, duration of the disease and the mode of labor were esti mated. The following procedures were perfor med in each new born infant: physical examination, de ter mination of Apgar sco re, measurements of birth weight and length, estimation of neurological status, clinical estimation of gesta tional age, ECG and ultrasono graphy of the brain, as well as the basic hema tologic, bio chem ical and micro bio logical ana lyses. Newborn infants of dia betic preg nancies were small for gestational age and of high birth weight. The levels of Na + , K + and Cl -ions did not show significant diffe rences between the investigated groups, where as the levels of total Ca and Mg were sig ni fi cantly decreased (2.18±0.59 and 0.65±0.17 mmol/L) (p<0.001) in the investigated group relative to the control group (2.42±0.53 and 0.81±0.09 mmol/L). The newborn infants of dia betic pregnancies pre sented with significantly decreased val ues of phosphates, bicarbonates and pH, whereas the dif fe rence in total osmo lality was not statistically significant. The level of glu cose at birth in the infants of diabetic mothers was lower (2.91±0.51 mmol/L) (p<0.001) than in the infants of healthy pregnancies (3.94±0.29 mmol/L). Glycemia lower than 2 mmol/L was recorded in 6.5% of infants of the in vestigated group. The level of bilirubin was significantly in crea sed (209.71±56.66 mmol/L) (p<0.001) in in fants of dia betic mothers compared to those of the healthy ones (155.70± 61.14 mmol/L), like the incidence of clinically manifested hyperbilirubinemia. Dis or ders of mater nal glucose homeo stasis cause biochemical dis orders such as hypo gly cemia, hypocalcemia, hyper bili ru bi nemia, hypomag ne semia and are associated with im paired maturation and congenital malforma tions of the fetus. Keywords: biochemical analyses, neonates, dia betes, pregnancyKratak sadr`aj: Cilj rada je utvrditi kako poreme}aj homeostaze glukoze uti~e na biohemijsku homeostazu i maturaciju ploda. Prospektivnim i randomiziranim ispitivanjem obu hva}ena su 102 novoro|en~eta, 31 novoro|en~e majki sa poreme}ajem homeostaze glukoze (I grupa) i 71 novoro|en~e zdravih majki (II grupa). Trudnicama je odre|ena prose~na starost, telesna visina, telesna te`ina, BMI, paritet, du`ina trajanja bolesti i pra}en je na~in poro|aja. Svakom novoro|en~etu ura|en je fizikalni pregled, odre|en Apgar skor, neurolo{ki status, izmerena telesna te`ina i du`ina, obavljena kli ni~ka procena gestacijske starosti, EKG i ultrazvu~ni pregled mozga kao i osnovne hematolo{ke, biohemijske i mikro bio lo{ke analize. Novoro|en~ad iz dijabeti~nih trudno}a manje su gestacijske starosti i ve}e telesne te`ine. Nivo jona Na + , K + i...

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