Metabolic and Haematological Profile of Infants Born to Gestational and Pregestational Diabetic Mothers

Sonia, Sheikh Farjana; Haque, Fazlul; Parvin, Ruma; Sultana, Azmeri; Afroze, Sharmin; Hassan, Mehdi

doi:10.3329/bjch.v44i2.51131

“…Maternal complications can include conditions like pre-eclampsia and polyhydramnios, while fetal complications range from macrosomia to various metabolic challenges 10 . The risk of congenital anomalies is notably linked to glycemic control during critical early pregnancy stages 11 . Long-standing pregestational diabetes can lead to vascular complications, adversely affecting the uteroplacental unit and potentially leading to intrauterine growth restriction (IUGR) and maternal hypertension 12 .…”

Section: Introductionmentioning

confidence: 99%

Impact of Gestational and Pre-Gestational Diabetes on Maternal Complications and Fetal Outcomes: A Comparative Observational Study at Rangpur Medical College Hospital

Nahida Sultana

2024

Global Journal of Medical Science

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Introduction: Diabetes in pregnancy, including gestational and pre-gestational diabetes, presents significant risks to both maternal and fetal health. Understanding the impact of these conditions on pregnancy outcomes is crucial for developing effective management strategies. Methods: This observational comparative study involved 300 pregnant women at Rangpur Medical College Hospital, divided into three groups: pre-gestational diabetic (Group A), gestational diabetic (Group B), and non-diabetic control (Group C). Data on socio-demographic characteristics, obstetric profiles, mode of delivery, maternal complications, and fetal outcomes were collected and analyzed. Result: The study meticulously analyzed socio-demographic characteristics, revealing no significant differences across the groups. In obstetric profiles, Group A (Pre-Gestational Diabetic) had a notably lower mean gestational age at delivery (36.06 ± 2.71 weeks) compared to Group B (Gestational Diabetic) and Group C (Control), with mean ages of 37.34± 1.12 and 38.46±1.13 weeks, respectively. Maternal complications were significantly higher in Group A at 47%, compared to 25% in Group B and 12% in Group C. Fetal outcomes showed marked variations: Group A had 95% stable births, 5% stillbirths, and 60% of neonates with Apgar scores ≤7 at 5 minutes. In contrast, Group B had 96% stable births, 4% stillbirths, and 27% of neonates with Apgar scores ≤7, while Group C reported 100% stable births and 11% with Apgar scores ≤7. Birth weight distribution indicated 24% of neonates in Group A weighed <2 kg, compared to 5% in Group B and 4% in Group C. NICU admissions were highest in Group A (44%), followed by Group B (29%) and Group C (11%). Perinatal complications like birth asphyxia (38% in Group A, 16% in Group B, 6% in Group C), hypoglycemia (22% in Group A, 10% in Group B, 4% in Group C), and hyperbilirubinemia (16% in Group A, 12% in Group B, 0% in Group C) were also significantly higher in diabetic groups. Conclusion: The presence of gestational or pre-gestational diabetes in mothers significantly impacts fetal outcomes and increases the risk of maternal complications. This study highlights the need for specialized care and vigilant monitoring in pregnancies complicated by diabetes to improve health outcomes for mothers and babies.

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“…Maternal complications can include conditions like pre-eclampsia and polyhydramnios, while fetal complications range from macrosomia to various metabolic challenges 10 . The risk of congenital anomalies is notably linked to glycemic control during critical early pregnancy stages 11 .…”

Section: Introductionmentioning

confidence: 99%

Impact of Gestational Diabetes and Pre-existing Diabetes in Fetal Outcome among Pregnancy Cases of Rangpur

Nahida Sultana

2023

Global Journal of Medical Science

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Introduction: Diabetes in pregnancy, including gestational and pre-gestational diabetes, presents significant risks to both maternal and fetal health. Understanding the impact of these conditions on pregnancy outcomes is crucial for developing effective management strategies. Methods: This observational comparative study involved 300 pregnant women at Rangpur Medical College Hospital, divided into three groups: pre-gestational diabetic (Group A), gestational diabetic (Group B), and non-diabetic control (Group C). Data on socio-demographic characteristics, obstetric profiles, mode of delivery, maternal complications, and fetal outcomes were collected and analyzed. Result: The study meticulously analyzed socio-demographic characteristics, revealing no significant differences across the groups. In obstetric profiles, Group A (Pre-Gestational Diabetic) had a notably lower mean gestational age at delivery (36.06 ± 2.71 weeks) compared to Group B (Gestational Diabetic) and Group C (Control), with mean ages of 37.34± 1.12 and 38.46±1.13 weeks, respectively. Maternal complications were significantly higher in Group A at 47%, compared to 25% in Group B and 12% in Group C. Fetal outcomes showed marked variations: Group A had 95% stable births, 5% stillbirths, and 60% of neonates with Apgar scores ≤7 at 5 minutes. In contrast, Group B had 96% stable births, 4% stillbirths, and 27% of neonates with Apgar scores ≤7, while Group C reported 100% stable births and 11% with Apgar scores ≤7. Birth weight distribution indicated 24% of neonates in Group A weighed <2 kg, compared to 5% in Group B and 4% in Group C. NICU admissions were highest in Group A (44%), followed by Group B (29%) and Group C (11%). Perinatal complications like birth asphyxia (38% in Group A, 16% in Group B, 6% in Group C), hypoglycemia (22% in Group A, 10% in Group B, 4% in Group C), and hyperbilirubinemia (16% in Group A, 12% in Group B, 0% in Group C) were also significantly higher in diabetic groups. Conclusion: The presence of gestational or pre-gestational diabetes in mothers significantly impacts fetal outcomes and increases the risk of maternal complications. This study highlights the need for specialized care and vigilant monitoring in pregnancies complicated by diabetes to improve health outcomes for mothers and babies.

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Neurodevelopmental Outcome in Infants of Gestational Diabetic Mother in a Tertiary Care Hospital, Dhaka, Bangladesh

Mannan

2024

JCMR

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Background: Diabetes Mellitus (DM) is one of the most common metabolic complications of pregnancy, with negative influences on maternal and fetal health. Infants of Diabetic Mothers (IDMs) are prone to develop both early and late complications. Evidences shows that diabetes in pregnancy have strong association with long-term adverse effects on brain development in babies born to mothers with gestational diabetes mellitus. Very few studies were done in this subcontinent regarding association of gestational diabetes mellitus and infant’s neurodevelopmental outcome. This study will help to find out this associations and thus to reduce poor neurodevelopmental outcome in infants of diabetic mothers by early detection and providing proper early childhood stimulation. Objective: To assess the neurodevelopmental outcome of infants born to mother with gestational diabetes mellitus. Methodology: This prospective observational study was conducted in the department of Neonatology and Institute of Pediatric Neurodisorder and Autism (IPNA), BSMMU, from March 2022 to September 2023. Neonates (N= 52) born at or after 34 weeks of gestation and born to gestational diabetic mother were enrolled in this study. Consent was taken from guardians. The newborns fulfilling the inclusion criteria were followed up for neurodevelopmental assessment at their 9 months of age by clinical psychologists assigned from Institute of Pediatric Neurodisorder and Autism (IPNA), BSMMU, who were blinded about infant’s diagnosis. Bayley scales of infant and toddler development (BSID III) was used for developmental assessment. In the Bayley III, cognitive development, expressive and receptive language and fine and gross motor development all were evaluated at 9 months of age. All data were recorded in a preformed questionnaire and analyzed by Statistical Package for Social Sciences (SPSS), version 25. Results: According to inclusion and exclusion criteria 58 newborn were enrolled and their blood samples were sent at 24 to 48 hours of age to see the laboratory parameters of metabolic and hematological profile. Among them 6 patients lost to follow up, so 52 infants were followed up for neurodevelopmental outcome at 9 months of age. Among the baseline characteristics of mother and neonate 48% mother needed drugs for glycemic control, while others were on dietary modification and 75% of the mothers had good glycemic control. Most of the neonate were born at term and were age appropriate, 18 patients needed NICU admission. Among the neonatal laboratory parameters hyperbilirubinemia was most common (30.8%) and hypoglycemia was second most common found in 15.4% of newborns. The most common morbidity was sepsis (17.3%). Overall adverse neurodevelopmental outcome was found among 14 (26.9%) neonate and 38 (73.1%) neonates had favorable outcome. Use of drugs and poor maternal glycemic control were found statistically significant in between adverse and favorable groups. (p-value- 0.041 and 0.000). Among the neonatal clinical parameters only hypoglycemia was found statistically significant in between these two groups. (p-value- 0.014) Multivariate logistic regression among these predictive factors showed only maternal poor glycemic control was significantly associated with adverse neurodevelopmental outcome (p-value=0.001). Conclusion: Maternal gestational diabetes can adversely affect on their infants neurodevelopment. Among the adverse outcome of three domains language delay was most common. Neonatal hypoglycemia, maternal poor glycemic control and use of drugs for GDM are significant predictors of adverse neurodevelopmental outcome in infants of gestational diabetic mother. Among them maternal poor glycemic control was significantly associated with adverse neurodevelopmental outcome.

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Metabolic and Haematological Profile of Infants Born to Gestational and Pregestational Diabetic Mothers

Cited by 4 publications

References 12 publications

Impact of Gestational and Pre-Gestational Diabetes on Maternal Complications and Fetal Outcomes: A Comparative Observational Study at Rangpur Medical College Hospital

Impact of Gestational and Pre-Gestational Diabetes on Maternal Complications and Fetal Outcomes: A Comparative Observational Study at Rangpur Medical College Hospital

Impact of Gestational Diabetes and Pre-existing Diabetes in Fetal Outcome among Pregnancy Cases of Rangpur

Neurodevelopmental Outcome in Infants of Gestational Diabetic Mother in a Tertiary Care Hospital, Dhaka, Bangladesh

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