Infant outcomes following diabetic pregnancies

Meur, Säumen; Mann, Nicholas

doi:10.1016/j.paed.2007.03.004

Cited by 15 publications

(23 citation statements)

References 25 publications

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“…Women with type 1 and type 2 diabetes have a much higher risk of serious adverse pregnancy outcomes, such as stillbirth, major congenital anomalies, neonatal morbidity and mortality [1][2][3][4]. Maternal diabetes is also associated with a higher risk of aberrant fetal growth.…”

Section: Introductionmentioning

confidence: 99%

“…Small for gestational age (SGA) is less often associated with maternal diabetes per se, but has been reported in association with severe vascular complications [9,10] and can result in higher neonatal morbidity and mortality. Both birthweight extremes in offspring of mothers with diabetes are associated with a higher risk of complications during the pregnancy, labour and neonatal period [2,11] as well as with a potential increase in diseases in childhood and adulthood, including obesity, cardiovascular disease, diabetes and metabolic syndrome [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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HbA1c and birthweight in women with pre-conception type 1 and type 2 diabetes: a population-based cohort study

et al. 2012

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Aims/hypothesis To investigate clinical and sociodemographic predictors of birthweight in singletons born to women with type 1 or type 2 diabetes. Methods Normally formed singleton live births and intrapartum stillbirths, born to women with pre-conception diabetes during 1996-2008, were identified from the population-based Northern Diabetes in Pregnancy Survey (n01,505). Associations between potential predictors and birthweight were analysed by multiple regression. Results Potentially modifiable independent predictors of increase in birthweight were pre-pregnancy care (adjusted regression coefficient [b]087.1 g; 95% CI 12.9, 161.3), increasing third-trimester HbA 1c ≤7% (53 mmol/mol) (b0310.5 g per 1% [11 mmol/mol]; 95% CI 246.3, 374.7) and increasing maternal BMI (b09.5 g per 1 kg/m 2 ; 95% CI 3.5, 15.5). Smoking during pregnancy (b0−145.1 g; 95% CI −231.4, −58.8), later gestation at first antenatal visit (b0−15.0 g; 95% CI −26.9, −3.0) and higher peri-conception HbA 1c (b0−48.2 g; 95% CI −68.8, −27.6) were independently associated with birthweight reduction. Pre-pregnancy nephropathy (b 0−282.7 g; 95% CI −461.8, −103.6) and retinopathy (b0−175.5 g; 95% CI −269.9, −81.0) were independent non-modifiable predictors of reduced birthweight, while greater maternal height was a non-modifiable predictor of increasing birthweight (b017.8 g; 95% CI 12.3, 23.2). Other predictors of birthweight increase were male sex, multiparity and increasing gestational age at delivery. Type or duration of diabetes, socioeconomic status and ethnicity were not associated with continuous birthweight. Conclusions/interpretation Poor glycaemic control before and throughout pregnancy is associated with abnormal fetal growth, with increasing peri-conception HbA 1c predicting weight reduction and increasing third-trimester HbA 1c predicting increased birthweight. Women with microvascular complications of diabetes may require increased surveillance to detect fetal growth restriction.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

HbA1c and birthweight in women with pre-conception type 1 and type 2 diabetes: a population-based cohort study

et al. 2012

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“…[8][9] Macrosomia is one of the major problems in these babies leading to birth injuries and perinatal asphyxia. 10 In this study, only 12% (3/25) babies were macrosomic, which may be due to better glycaemic control in the mothers. Fifteen percent IDMs suffered from birth asphyxia in Alam's study.…”

Section: Resultsmentioning

confidence: 58%

A Study of Clinical, Metabolic and Haematological Profile in Infants of Diabetic Mothers, Karad

Koppad¹,

Karanjkar²,

Sukumaran³

2017

jemds

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BACKGROUNDDiabetes is one of the most common metabolic disorder complicating pregnancy. Infants born to diabetic mothers (IDMs) are at increased risk of serious complications compared to those of nondiabetic mothers. This study focuses on various clinical, metabolic and haematological complications of infants of diabetic mothers, both gestational and pregestational diabetes. MATERIALS AND METHODSThis hospital-based prospective observational study was conducted in Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, over a period of 9 months duration. 25 infants of diabetic mothers admitted to the NICU were included in the study. Maternal history regarding diabetes mellitus was obtained and complete neonatal examination was performed and recorded. Relevant biochemical and haematological tests as well as echocardiography was conducted in all the neonates. RESULTSOf the 25 neonates, 21 (84%) were born to mothers with gestational diabetes and 4 (16%) were born to mothers with pregestational diabetes. Most of them, 14 (56%) were delivered by normal vaginal delivery. 2 (8%) were born prematurely. Majority of them were AGA (68%). The most common haematological and metabolic abnormalities recorded were hypoglycaemia (32%), polycythaemia (56%) and hyperbilirubinaemia (48%). Congenital malformations were seen in 28% babies in the form of heart disease. There were no neonatal deaths in our study. CONCLUSIONMaternal diabetes has an adverse effect on foetal growth, glucose metabolism, oxygenation and preparation for extrauterine life. Our study suggests that hypoglycaemia and polycythaemia remain the most common complication in infants of diabetic mothers. They are also at a greater risk for congenital heart diseases.

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“…Gestational diabetes is one of the most common metabolic disorders in pregnancy period and is associated with a higher risk of short-and long-term neurocognitive abnormalities in the offspring [1,2,4,5,[7][8][9]28,29,38,39]. Diabetes during pregnancy period as a result of metabolic abnormalities and perinatal complications may be associated with developing brain abnormalities in offspring, including long-lasting neurological impairment, impairments in attention and memory, hyperactivity, poorer general cognitive function and altered social behaviors [1,2,6,[39][40][41][42][43][44][45].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, many of the developmental effects of gestational diabetes on the fetal CNS can be attributed to maternal hyperglycemia and fetal hyperglycemia/hyperinsulinemia [5,38,39]. In diabetic pregnancies, the fetal blood glucose concentration is fairly high as the glucose in the mother's blood crosses the placenta freely.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Function in Offspring of Mothers with Gestational Diabetes–The Role of Insulin receptor

JavadHami

Hosseini

Ivar

et al. 2016

MOJAP

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There is increasing evidence that the offspring of women with gestational diabetes during pregnancy are at increased risk for the neurocognitive abnormalities. Moreover, the exact molecular mechanism by which gestational diabetes affects the developing central nervous system (CNS) remains to be defined. In the recent decades, it found that the Insulin has a crucial role in the development and function of the brain in both fetuses and adults. The researchers found that the alteration in expression/localization of insulin receptor (InsR) in the brain may be part of the cascade of events through which gestational diabetes affects the newborn's CNS structures. Dissecting out the mechanisms responsible for gestational diabetes-related changes in the development of CNS is helping to prevent from impaired neurocognitive functions in offspring.

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Infant outcomes following diabetic pregnancies

Cited by 15 publications

References 25 publications

HbA1c and birthweight in women with pre-conception type 1 and type 2 diabetes: a population-based cohort study

HbA1c and birthweight in women with pre-conception type 1 and type 2 diabetes: a population-based cohort study

A Study of Clinical, Metabolic and Haematological Profile in Infants of Diabetic Mothers, Karad

Cognitive Function in Offspring of Mothers with Gestational Diabetes–The Role of Insulin receptor

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