TY - JOUR
T1 - Continuing Neonatal Morbidity in Infants of Women with Class a Diabetes
AU - Diamond, Michael Peter
AU - Salyer, Sheron L.
AU - Vaughn, William K.
AU - Cotton, Robert B.
AU - Entman, Stephen S.
AU - Boehm, Frank H.
PY - 1984/11
Y1 - 1984/11
N2 - Despite having implemented rigorous glucose control for women with gestational diabetes early in the third trimester, we found excessive morbidity among the neonates of these women. To accurately assess the risk of newborn complications, we did a five-year review (1977 to 1981) of infants of class A diabetic mothers to determine the incidence and scope of morbidity in these infants. Fifty-one infants of class A mothers were identified (group 1) and randomly matched with 102 infants of nondiabetic mothers (group 2). The distribution of morbidity between the two groups was as follows: Hypoglycemia 9/51 (18%) vs 0/102 (P <.001); birth injuries 4/51 (8%) vs 1/102 (2%) (P <.05); pulmonary edema 3/51 (6%) vs 0/102 (P <.05); respiratory distress 4/51 (8%) vs 7/102 (7%) (NS); macrosomia 18/51 (35%) vs 23/102 (23%) (NS); and hyperbilirubinemia 3/51 (6%) vs 8/102 (8%) (NS). There were two fetal deaths and three infants with major congenital anomalies among the diabetic pregnancies compared to none from the nondiabetic pregnancies. Compared to insulin-dependent diabetes, class A diabetes is accompanied by relatively mild metabolic disturbances in the mother. On the other hand, the infant of a mother with class A diabetes appears to be at risk for serious and life-threatening complications, both before and after birth. These results raise the question of whether earlier identification, subsequent meticulous diabetic management, and altered timing of delivery might reduce the complications experienced by these infants.
AB - Despite having implemented rigorous glucose control for women with gestational diabetes early in the third trimester, we found excessive morbidity among the neonates of these women. To accurately assess the risk of newborn complications, we did a five-year review (1977 to 1981) of infants of class A diabetic mothers to determine the incidence and scope of morbidity in these infants. Fifty-one infants of class A mothers were identified (group 1) and randomly matched with 102 infants of nondiabetic mothers (group 2). The distribution of morbidity between the two groups was as follows: Hypoglycemia 9/51 (18%) vs 0/102 (P <.001); birth injuries 4/51 (8%) vs 1/102 (2%) (P <.05); pulmonary edema 3/51 (6%) vs 0/102 (P <.05); respiratory distress 4/51 (8%) vs 7/102 (7%) (NS); macrosomia 18/51 (35%) vs 23/102 (23%) (NS); and hyperbilirubinemia 3/51 (6%) vs 8/102 (8%) (NS). There were two fetal deaths and three infants with major congenital anomalies among the diabetic pregnancies compared to none from the nondiabetic pregnancies. Compared to insulin-dependent diabetes, class A diabetes is accompanied by relatively mild metabolic disturbances in the mother. On the other hand, the infant of a mother with class A diabetes appears to be at risk for serious and life-threatening complications, both before and after birth. These results raise the question of whether earlier identification, subsequent meticulous diabetic management, and altered timing of delivery might reduce the complications experienced by these infants.
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U2 - 10.1097/00007611-198411000-00009
DO - 10.1097/00007611-198411000-00009
M3 - Article
C2 - 6494959
AN - SCOPUS:0021748328
SN - 0038-4348
VL - 77
SP - 1386
EP - 1388
JO - Southern medical journal
JF - Southern medical journal
IS - 11
ER -