Neonatal Outcomes of Mothers with Gestational Diabetes Mellitus at Faculty of Medicine Vajira Hospital, Navamindradhiraj University

Article Sidebar

PDF
Published: Mar 1, 2017
Keywords:
Gestational diabetes mellitus neonatal outcomes

Main Article Content

Tikamporn Tongbunnum
Department of Pediatrics, Faculty of Medicine Vajira Hospital, Navamindradhiraj University. Bangkok, Thailand
Siwiluck Kanchanabat
Department of Pediatrics, Faculty of Medicine Vajira Hospital, Navamindradhiraj University. Bangkok, Thailand

Abstract

Objectives: To study neonatal outcomes of infants born to mothers with gestational diabetes mellitus and factors associated with neonatal hypoglycemia.


Methods: Retrospective study of infants of diabetic mothers at Faculty of Medicine, Vajira Hospital, Navamindradhiraj University between 1st January 2011 and 31th March 2014. Data characteristics were collected from medical records and analyzed.


Results: There were 310 infants born to diabetic mothers. (4.6% of all live births). Nine infants were excluded, while 301 infants were included in this study. The subjects were 52.2% male, 15.6% preterm, and 49.2% delivered by Cesarean section. Mean gestational ages was 37.82 ± 1.57 weeks. Neonatal hypoglycemia was noted in 33.2%, hyperbilirubinemia in 30.6%, sepsis in 6.6%, respiratory problem in 5.3%, congenital heart disease in 2.3%, hypocalcemia in 1% and polycythemia in 0.3%, respectively. Factors associated with neonatal hypoglycemia were insulin injection in GDM mothers (OR 2.42; 95%CI 1.29-4.57, p=0.006), first maternal ANC at second trimester (OR 2.20; 95%CI 1.21-3.99, p=0.009), large for gestational age infants (OR 2.15; 95%CI 1.15-4.00, p=0.016), preterm infants (OR 2.37; 95%CI 1.16-4.86, p=0.019). Neonatal hypoglycemia resulted in longer hospital stay of more than 3 days (OR 1.90; 95%CI 1.12-3.21, p=0.017).


Conclusion: Neonatal hypoglycemia was the most common complication in the infants born to diabetic mothers. Insulin use in mothers, first ANC after first trimester, preterm and large for gestational age infants increased the risk of neonatal hypoglycemia.

Article Details

How to Cite
Tongbunnum, T., & Kanchanabat, S. (2017). Neonatal Outcomes of Mothers with Gestational Diabetes Mellitus at Faculty of Medicine Vajira Hospital, Navamindradhiraj University. Vajira Medical Journal : Journal of Urban Medicine, 61(1), 21–32. Retrieved from https://he02.tci-thaijo.org/index.php/VMED/article/view/194664
Issue
Vol. 61 No. 1 (2017): JAN - MAR 2017
Section
Original Articles

References

1. Gabbe SG, Graves CR. Management of diabetes mellitus complicating pregnancy: high- risk pregnancy series: an expert’s view. Obstet Gynecol. 2003; 102: 857-68.

2. King H. Epidermiology of glucose intolerance and gestational diabetes in woman of childbearing age. Diabetes Care. 1998; 21(2):B9-13.

3. Moor TR. Diabetes inpregnancy. In: Creasy RK, Resnik R, editors. Maternal-fetal medicine. 4th ed. Philadelphia: WB Saunders Company; 1999. p.964-95.

4. Cunningham FG. Diabetes. In: Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap III LC, Wenstrom KD, editors. Williams Obstetrics. 22nd ed. New York: Mc Graw-Hill; 2005. p.1169-84.

5. Sirirat S, Deerochanawong C, Sunthornthepvarakul T, Jinayon P. Gestational diabetes mellitus. J Med Assoc Thai. 1992; 75: 315-9.

6. Hirst JE, Raynes-Greenow CH, Jeffery HE. Systematic review of trends of gestational diabetes mellitus in Asia. J Diabetol. 2012; 3(3):4-5.

7. Cunningham FG. Diabetes. In: Cunningham FG , Gant NF, Leveno KJ, Gilstrap III LC, Hauth JC, Wenstrom KD, editors. Williams Obstetrics, 21th ed. New York: McGraw-Hill; 2001. p.1360-77.

8. Atul G, Alka G. Management of diabetes mellitus during pregnancy. Obstet Gynecol Commun. 2000; 2(4):43-50.

9. Landon MB, Gabbe SG. Diabetes mellitus. In: Barron WM, Lindheiner MD, Davison JM, editors. Medical disorders during pregnancy. 2th ed. St. Louis: Mosby-Year Book Inc; 1995. p.63-88.

10. Schoetzau A, Hillebrand B. Neonatal morbidity of children of diabetic mothers. Z Geburtshilfe Perinatol. 1990; 194(2): 58-64.

11. Nimsakul A. Neonatal hypoglycemia of diabetic mother born in BhumibolAdulyadej Hospital. Royal Thai Air Force Medical Gazette. 2009;55(2): 1-12.

12. Nikonpongsin P. The characteristics of infants of diabetic mothers associated with neonatal hypoglycemia at Faculty of Medicine, Vajira Hospital [thesis]. Bangkok: University of Bangkok Metropolis; 2008.

13. Wilker RE. Hypoglycemia and hyperglycemia.In: Cloherty JP, Eichenwald EC, Hansen AR, Stark AR, editors. Manual of neonatal care. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2012. p.285.

14. Arcara KM. Blood chemistryes and body fluids. In: Tschudy MM, Rcara KM,editors. The Harriet lane handbook.19th ed. Philadelphia: Saunders; 2012. p.639-46.

15. Smith VC. The high-risk newborn anticipation, evaluation,management, and outcome.In: Cloherty JP, Eichenwald EC, Hansen AR, Stark AR,editors. Manual of neonatal care. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2012. p.74-88.

16. Farooq MU, Ayaz Ab. Maternal and Neonatal Outcomes in Gestational Diabetes Mellitus. Int J Endocrinol Metab. 2007;3: 109-15.

17. Parritz AL, Cloherty JP. Diabetes mellitus. In: Cloherty JP, Eichenwald EC, Hansen AR, Stark AR,editors. Manual of neonatal care. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2012. p.285.

18. Pederson J. Weight and length at birth of infants of diabetic mothers. Acta Endocrinol. 1954;16: 330-42.

19. Cornblath M, Schwartz R. Disorders of carbohydrate metabolism in infancy. Major Probl Clin Pediatr. 1976; 3: 1-483.