Clinical Manifestations and Outcomes of Symptomatic Infants Born to Diabetic Mothers

San-Nan Yang ； Hsin-Chun Huang ； Chih-Lu Wang ； Yung-Ming Hsu ； Mei-Hui Ouyang ； Tan-Yung Ko ； Feng-Shun Chen ； Chih-Cheng Chen ； Mei-Yung Chung ； Chia-Yo Ou ； Chung-Bin Huang ； Chieh-An Liu

《Clinical Neonatology》 12卷2期 (2005/12) Pp. 39-44

https://doi.org/10.7098/CN.200512.0039

並列摘要

Background: The purpose of this study is to present the clinical manifestations and outcomes of infants born to mothers with insulin-dependent diabetes mellitus (IDDM) or gestational diabetes mellitus (GDM).
Methods: From 1996 to 2003, we collected infants born to IDDM or GDM mothers who required admission to our neonatal intensive care unit. Their clinical manifestations and outcomes were described and analyzed.
Results: The prevalence of infants born to diabetic mothers (IDM) was 1.3% of all live births, and the frequency of symptomatic IDMs was 0.4% (84 cases) of all live births. The male to female ratio of these symptomatic IDMs was about 2/1. The mean birth weight was 3506 ± 844 g compared to 3134 ± 530 g in the control group. Fifty-six percent of these IDMs were large for gestational age, 40.5% were appropriate for gestational age, and only 3.5% were small for gestational age. The frequency of macrosomia was 28.6% compared to 3.2% in the control group. Hypoglycemia (glucose level ＜ 40 mg/dl) was documented in 46.4% (39/84) of the infants. Other neonatal morbidities were hyper-bilirubinemia (52 cases), hyponatremia (2), hyperkalemia (15), hypocalcemia (17), polycythemia (1), gastrointestinal (GI) problems (14), respiratory distress (48), cardiac abnormalities (33), and brachial plexus injury (2). There was one neonatal death. Three infants with profound and persistent hypoglycemia had seizures during hospitalization. They all had mixed developmental delays and abnormal EEGs on follow-up.
Conclusions: Infants born to diabetic mothers are at risk of macrosomia, hypoglycemia and other neonatal morbidities.
Profound and persistent neonatal hypoglycemia in IDMs is associated with long-term neurological dysfunction.

並列關鍵字

diabetes mellitus ； gestational diabetes mellitus ； infant born to diabetic mother IDM ； macrosomia ； hypoglycemia