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THE NEONATAL OUTCOME IN INFANT BORN TO GESTATIONAL AND PRE-GESTATIONAL DIABETIC MOTHERS

Authors: Duha E. Kadhum ضحى عماد كاظم --- Sawsan S. Abbas سوسن ساطع الحيدري --- Deia K. Khalaf ضياء كاظم الاسدي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2017 Volume: 15 Issue: 3 Pages: 268-274
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Diabetes is the 2nd commonest medical complication of pregnancy after hypertension. Infants of diabetic mothers are those infants born to a mother who suffers from diabetes mellitus, but the term refers especially to infants born to a mother who has persistently elevated blood sugar during pregnancy.Objective:To study the complications in infants of diabetic mothers and the difference in the complications between infants of gestational and pre-gestational diabetic mothers.Methods:A cross sectional observational study carried out on (100) neonates of diabetic mothers that delivered in Al-Imamein Al-Kadhimein Medical City; the data was collected between 1st of September 2015 to 1st of December 2015. Maternal history was taken about type of diabetes and babies were divided into 2 groups; 1st group was infants of pregestational diabetic mothers and 2nd group was infants of gestational diabetic mothers. Thorough physical examination of these infants at birth at the neonatal care unit was done. Laboratory investigations included blood sugar, serum calcium, hematocrit, total serum bilirubin and echocardiograph was done in all babies but chest x-ray, abdominal ultrasound, brain ultrasound and electrocardiogram were done whenever indicated.Results:The 1st group (36 cases) 36% of infants was product of mothers having pregestational diabetes and the 2nd group (64 cases) 64% infants of gestational diabetic mothers. Mothers were delivered by cesarean section in 69%. Mothers were primigravida in 31%. Female 59% to male ratio 1.4:1. Hypoglycemia at birth was documented in 39% of cases, was nearly equal in both groups (20%, 19%) respectively. Hypocalcemia in 18%, was more in infants of pregestational diabetic mothers (11% and 7%) respectively. Respiratory complications were the most prominent complications 41 % nearly equal in both groups (22% and 19%) respectively. Macrosomia seen in 23%, more in infants of gestational diabetic mothers (7% and 16%) respectively. Forty % of infants of both group have been discharged in the first 24 hours.Conclusion:The respiratory complications were the most prominent followed by hypoglycemia that occurred mainly to infants of pregestational diabetic mothers. There are statistical differences in infants of pregestational diabetic mothers regarding hypoglycemia, hypocalcemia and respiratory complications. Macrosomia is more in infants of gestational diabetic mothers.Keywords:Neonate, infants, gestational, pregestational diabetes. Citation:Kadhum DE, Abbas SS, Khalaf DK. The neonatal outcome in infant born to gestational and pre-gestational diabetic mothers. Iraqi JMS. 2017; Vol. 15(3): 268-274. doi: 10.22578/IJMS.15.3.8


Article
Fetal Parameters and Early Evidence of Fetal Macrosomia in Prepregnancy Diabetic Women

Authors: Hala A. G. AL Rawi --- Ban Hadi --- Najlaa Hanon
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2018 Volume: 17 Issue: 2 Pages: 75-79
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Diabetes in pregnancy with macrosomia is an important risk factor for neonatal morbidity and mortality. Prediction ofmacrosomia is significantly improved by adding ultrasound to clinical findings. Objective: For earlier detection of macrosomia inprepregnancy diabetic mothers using fetal growth profile including biparietal diameter, femoral length, and also abdominal circumference (AC). Patients and Methods: A historical prospective cohort study was performed at National Endocrine and Diabetic Center in addition to theObstetrics and Gynecology Department at Al‑Yarmouk Hospital for 2 years, from September 2014 to 2016. A hundred and sixty pregnantwomen were enrolled in this study, 80 of them with a history of prepregnancy diabetes mellitus were taken as a patient group and the other 80 pregnant women with a compatible gestational age and without a history of diabetes mellitus were taken as a comparison group. Abdominalultrasound was done for patients in both groups at 20, 28, and 36 weeks of gestation and then birth weight was measured for each. Results werecompared between two groups. Results: The incident of macrosomia was 30% in patient group and 10% in comparison group. Regarding earlyprediction of macrosomia by ultrasound using biparietal diameter, femoral length, and AC, the results of the current study revealed that those macrosomic babies have higher femoral length, AC but not biparietal diameter in comparison with babies of average weight using ultrasound performed at 20‑week gestation and repeated at 28 and 36 weeks. Conclusion: In diabetic mother, fetal macrosomia can be predicted by ultrasound during pregnancy as early as 20‑week gestation.

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