Neonatal Hypoglycemia

Sann, L.

doi:10.1159/000243296

Cited by 15 publications

(10 citation statements)

References 13 publications

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“…[3][4][5] Suboptimal prenatal care along with poor maternal glycemic control, vasculopathy, infection, and pregnancy-induced hypertension are factors associated with poor perinatal outcome. 1,6,7 Congenital malformations, [8][9][10] macrosomia, 3,11,12 respiratory distress syndrome (RDS), 13,14 hypoglycemia, 3,[15][16][17] hyperbilirubinemia 18 and hypocalcemia 19 are some of the conditions most frequently diagnosed in the offspring of diabetic women.…”

mentioning

confidence: 99%

“…For example, neonatal hypoglycemia, known to affect 5% to 30% of infants of diabetic mothers, can be avoided in some cases by early breastfeedings 20 or formula-feedings and/or by intravenous dextrose administration. 15,21 Comprehensive care of pregnant womenwithdiabetesmellitushasbeenextensively described, 22 yet guidelines regarding the care of the infant are less well established. The purpose of this investigation was to characterize the clinical outcome for a large cohort of infants of diabetic mothers delivered during a 3-year period, and to examine the efficacy of our institutional diagnostic and therapeutic approach to their care.…”

mentioning

confidence: 99%

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Management of Infants of Diabetic Mothers

Cordero¹,

Treuer²,

Landon³

et al. 1998

Arch Pediatr Adolesc Med

141

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To describe the clinical outcome of infants born to mothers with gestational diabetes mellitus (GDM) and preexisting insulin-dependent diabetes mellitus (IDDM).Setting: A tertiary care regional perinatal center with a specialized diabetes-in-pregnancy program.Design: Case series.Results: Five hundred thirty infants were born to 332 women with GDM and 177 women with IDDM. Thirty-six percent of these 530 newborns were large for gestational age, 62% were appropriate for gestational age, and only 2% were small for gestational age. Seventy-six (14%) of all infants were born before 34 weeks' gestation, 115 (22%) between 34 and 37 weeks of gestation, and 339 (64%) at term. Two hundred thirty-three infants (47%) were admitted to the neonatal intensive care unit due to respiratory distress syndrome(RDS),prematurity,hypoglycemia,orcongenitalmalformation. Hypoglycemia (more common among infants of maternal diabetic classes C through D-R) was documented in 137 (27%) of all newborns. One hundred eighty-two infants (34%) had RDS of varying severity. Polycythemia (5% of infants), hyperbilirubinemia (25%), and hypocalcemia (4%) were other morbidities present. Two hundred fortyfour infants were admitted for routine care and enteral feedings. Forty-three of these newborns required subsequent transfer to the neonatal intensive care unit for treatment of hypoglycemia (16 cases), RDS (19 cases), or both (8 cases). Routine care failures were more common among infants whose mothers had advanced diabetes, but less frequent among breast-fed infants.Conclusions: With modern management, fewer morbidities can be expected in infants of diabetic mothers. Those infants born to women with IDDM remain at risk for hypoglycemia, which can be treated in one half of the cases by enteral feedings alone. The majority of cases of RDS are mild and require short admissions to special care nurseries. Optimal care of infants of diabetic mothers is based on prevention, early recognition, and treatment of common conditions.Severecongenitalmalformations,significantprematurity,RDS,recurrenthypoglycemicepisodes,andasymptomatic infants of women with advanced IDDM should be admitted to special care nurseries. Breast-feeding among women with GDM and IDDM should be encouraged.

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mentioning

confidence: 99%

mentioning

confidence: 99%

Management of Infants of Diabetic Mothers

Cordero¹,

Treuer²,

Landon³

et al. 1998

Arch Pediatr Adolesc Med

141

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“…The role of glucocorticoids in this regard during the pre natal and neonatal periods has not been as well characterized, however. Administration of cortisol to chronically hypoglycemic hu man newborns has been found beneficial in restoring glucose balance [13,14]. In newborn rats, pharmacological doses of corticosterone have been reported to elevate plasma glucose levels within the first day [15,16] and to nega tively influence future glucostasis during adult life [15].…”

Section: Discussionmentioning

confidence: 99%

“…We were interested to know if correlations existed between endogenous lev els of glucose and glucocorticoids, and if adre nal steroids were capable of acutely influenc ing plasma glucose levels. The latter idea was prompted by reports that glucocorticoid treat ment attenuated hypoglycemia in human in fants [13,14] and that pharmacological doses of corticosterone produced moderate hyper glycemia in newborn rats [15,16].…”

mentioning

confidence: 99%

Twenty-Four Hour Profiles of Glucose, Corticosterone and Adrenocorticotropic Hormone during the First Postnatal Day in Rats

Nagaya

Widmaier²

1993

Neonatology

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Soon after birth, mammals are often confronted with the challenges of hypoxia, hypothermia and hypoglycemia. The incidence of the latter in the human population is roughly 2-20% of all live births. We characterized the glucose profile over the first 24 h of postnatal life in a large population of suckling, nonfasted rats. Approximately 63% were hypoglycemic (plasma glucose < 60 mg/dl) during the first 4 h after birth; from 6 to 24 h after birth this number was reduced to 10%. Low glucose levels in the first hours after birth were significantly associated with high plasma glucocorticoid and adrenocorticotropic hormone levels. Glucocorticoid injections 2 h after birth that elevated plasma corticosterone to high physiological levels for 1-2 additional hours significantly increase plasma glucose levels compared to vehicle-injected controls. These results suggest that, like the human newborn, rat pups are susceptible to developing neonatal hypoglycemia with about the same frequency as in babies. Also, the hypothalamic-pituitary-adrenocortical (HPA) axis appears to be active from birth and may be responsive to hypoglycemia stress during this early period (contrary to later neonatal ages when the HPA axis is quiescent in rats). Finally, glucocorticoids appear to prevent the development of hypoglycemia shortly after birth.

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“…Diyabetik anne bebeklerinde en sık görülen metabolik komplikasyonlar; hipoglisemi, hipokalsemi ve hipomagnezemidir (9,(16)(17)(18)(19). DAB'larda özellikle doğumu izleyen ilk 90 dakika içinde hipoglisemi gelişmektedir.…”

Section: Gereç Ve Yöntemunclassified

Di̇yabeti̇k Anne Bebekleri̇ni̇n Yeni̇doğan Dönemi̇ Sorunlari

Ince¹,

Takçı²,

Gümüşer³

2014

J Contemp Med

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ÖZETAmaç: Diyabet gebelikte fetal gelişimi etkileyen ve yenidoğanlarda metabolik bozukluklara yol açan bir hastalıktır. Çalışmamızda diyabetik anne bebeklerinin yenidoğan sorunlarının ve gebelikte anneye ait risk faktörlerinin değerlendirilmesi amaçlandı.Gereç ve yöntem: Çalışmada Gaziosmanpaşa Üniversitesi Tıp Fakültesi Hastanesinde Ocak 2013-Aralık 2013 tarihleri arasında doğan ve yenidoğan yoğun bakım ünitesinde izlenen 31 diyabetik anne bebeğinin morbidite oranları ve annelere ait demografik özellikleri retrospektif olarak değerlendirildi.Bulgular: Çalışmaya 31 diyabetik anne bebeği alındı. Annelerden 7'si (%22,6) insuline bağımlı diyabet ve 24'ü (%77,4) gestasyonel diyabet tanısı ile takip edilmekte idi. Annelerin ortalama yaşı 32,6±7,9 yıl, ortalama glikolize hemoglobin (HbA1c) değerleri % 5,4±1 (4,2-10,2) saptandı. Bebeklerin ortalama gebelik haftaları 37,5±1,5 hafta, ortalama doğum ağırlığı 3322,5± 695,8 gr. idi. Makrozomi sıklığı %32,2 idi. Bebeklerde hipoglisemi %9,7, hipokalsemi %3,2, polistemi %6,5, anemi %6,5, trombositopeni %9,7, hiperbilirubinemi % 41,9, respiratuvar distres sendromu %12,9, doğuştan anomali %3,7 oranında bulundu. Annenin HbA1c düzeyi ile hipoglisemi, hipokalsemi, polistemi, anemi, respiratuar distres sendromu arasında ilişki bulunmadı (p>0,05).Sonuç: Diyabetik anne bebeklerinde uygun medikal yaklaşım, obstetrik bakım ve neonatal yaklaşım ile komplikasyonlar önlenebilir. Gestasyonel diyabetin tanımlanması, hipergliseminin kontrol altına alınması, risk faktörlerinin belirlenmesi ve yenidoğan yoğun bakımda izlem ihtiyacı olamayan bebeklerin doğumdan sonra ilk saatlerde anne yanına verilmesi ve anne yanında yakın takibi ile morbiditenin azaltılması mümkündür.Anahtar kelimeler: diyabetik anne bebeği, komplikasyon ABSTRACT Objectives: Diabetes is a disease that effects fetal development during pregnancy and leads metabolic disorders in newborns. In this study, we aimed to evaluate the problems of infants of diabetic mothers and to determine risk factors of mothers during pregnancy. Material and Methods:The morbidity rates of 31 infants of diabetic mothers who were born and followed in neonatal intensive unit between January 2013 and December 2013 at Gaziosmanpasa University and demographic properties of mothers were retrospectively evaluated.Results: A total of 31 infants were included. The incidence of insulin dependent diabetes mellitus was %22,6 and the incidence of gestational diabetes was 77,4%. Mothers' mean age was 32,6±7,9 years and HbA1c level was 5,4±1 (4,2-10,2). The mean gestational age of infants was 37,5±1,5 weeks and the mean birth weight of infants was 3322,5± 695,8 g. Macrosomia was present in 32.2% of infants. Hypoglycemia was present in 9,7% of infants, hypocalcemia was seen 3.2%, polycytemia was seen 6.5%, anemia was seen 6.5%, thrombocytopenia was seen 9.2%, hyperbilirubinemia was seen 41.9%, respiratory distress syndrome was seen 12.9%, congenital anomaly was seen 3.7% of all infants. There was no correlation between HbA1c levels of mothers and hypoglycemia, hypoca...

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Neonatal Hypoglycemia

Cited by 15 publications

References 13 publications

Management of Infants of Diabetic Mothers

Management of Infants of Diabetic Mothers

Twenty-Four Hour Profiles of Glucose, Corticosterone and Adrenocorticotropic Hormone during the First Postnatal Day in Rats

Di̇yabeti̇k Anne Bebekleri̇ni̇n Yeni̇doğan Dönemi̇ Sorunlari

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