Morbidities and Mortalities among Infant of Diabetic Mother in a Newly Established Scabu of a Tertiary Care Hospital, Bangladesh

Abstract

Introduction: Diabetes mellitus has long been associated with perinatal morbidity and mortality. It complicates 2% to 3% of all pregnancies; 90% of these cases present with gestational diabetes mellitus. In our population Gestational diabetes mellitus develops among 6.7% of all pregnancies. Macrosomia (28%), hypocalcaemia (22%), hyperbillirubinaemia (19%), polycythemia (34%), perinatal asphyxia, birth injury and congenital anomaly (6-9%) are the complications of infant of diabetic mother (IDM). Materials and Methods:This prospective observational study was done in the newly established Special Care Neonatal Unit (SCANU) to determine the morbidities and mortalities among IDM babies admitted in to Mymensingh Medical College Hospital (MMCH), Bangladesh from January to March 2015. A total 50 IDM patients who admitted during this period were recruited in the study irrespective of their gestational age, birth weight, pattern and duration of maternal diabetes. Results: Male and female patients were 29 (58%) and 21 (42%). Caesarian and vaginal delivery were 43 and seven cases. Gestational and pre-gestational diabetes mothers were 35 (70%) and 15 (30%) respectively. The important morbidities in order of frequency were found perinatal asphyxia (50%), macrosomia (48%), neonatal jaundice (44%), hypoglycaemia (40%), hypocalcaemia (36%), polycythemia (28%), CHD (20%), neonatal sepsis (20%), birth trauma (12%), TTN (6%), RDS (6%), GIT problem (2%) respectively. Mortality was recorded in three patients. Conclusion: Our observations show the high prevalence of IDM (24/1000 live birth) and their various complications. Mortality and morbidity is a bit higher in IDM. Our health policy maker should give adequate emphasis on management of IDM babies.

Gestational diabetes mellitus (GDM) and adverse pregnancy outcome in South Asia: A systematic review

“…Six studies 8,9,25–28 showed that higher percentage of pregnant women with GDM have a foetal outcome of macrosomia compared to women with no GDM. Akhter et al 23 and Islam et al 24 reported that macrosomia was highly prevalent among GDM mother, although the findings were inconclusive due to lack of a control group.…”

“…All the studies were conducted in hospital settings except one study which was carried out in rural areas of Assam, India 26 . In five studies, GDM was diagnosed in accordance with the WHO criteria and was measured performing an oral glucose tolerance test (OGTT), 9,23,25–27 while in other studies ( n = 3), patient recall were used 8,24,28 …”

“…Characteristics of included studies are shown in Table 2 . Among the eight studies included, 8 , 9 , 23 , 24 , 25 , 26 , 27 , 28 six studies 8 , 24 , 25 , 26 , 27 , 28 utilized prospective observational study design while the remaining two studies 9 , 23 used a retrospective study design. All the studies selected were primary studies carried out in South Asian countries.…”

“…All the studies selected were primary studies carried out in South Asian countries. Five studies were conducted in India, 8 , 9 , 26 , 27 , 28 one in Pakistan, 23 one in Bangladesh 24 and one in Sri Lanka. 25 All the studies were conducted in hospital settings except one study which was carried out in rural areas of Assam, India.…”

“…However, one should be cautious while interpreting the findings of the research as the quality of the included studies was relatively moderate 8,9,23,25,27,28 to poor 24,26 …”