Adverse Neonatal Outcomes Associated With Pregestational Diabetes in Infants Born Premature [08F

Abstract

INTRODUCTION: Pregestational diabetes (PGDM) is a known risk factor for preterm delivery. It is unclear if infants born preterm to PGDM mothers are at higher risk of adverse outcomes compared to other premature infants. The objective of this study is to quantify the neonatal complications associated with PGDM in infants born premature. METHODS: This was a retrospective cohort study of all non-anomalous singleton neonates born in Texas from 2006-2014. Analysis was limited to births between 24 and 36 weeks gestation. Results were stratified by PGDM status. Neonatal outcomes of interest included infant death, neonatal intensive care unit (NICU) admission, low 5 minute APGAR scores, assisted ventilation >6 hrs, surfactant administration and seizures. Multivariate logistic regression analysis was performed to estimate the association between PGDM and neonatal outcomes controlling for potential confounding variables. RESULTS: After exclusions, 277,210 births were analyzed. The prevalence of PGDM was 1.5%. In infants born premature, PGDM was associated with an increased risk of infant death (2.3% vs. 2.0%, aOR 1.39; 95% CI [1.12, 1.73]), risk of low 5 min Apgar score (8.1% vs. 6.2%, aOR 1.50; 95% CI [1.33, 1.70]), risk of prolonged assisted ventilation (9.4% vs. 6.2%, aOR 1.61; 95% CI [1.44, 1.80]), risk of requiring surfactant treatment (3.1% vs. 2.1%, aOR 1.61; 95% CI [1.33, 1.93]), risk of NICU admission (49.4% vs. 036.1%, aOR 1.72; 95% CI [1.61, 1.84]) and risk of seizures (0.19% vs. 0.06%, aOR 3.06; 95% CI [1.49, 6.29]). CONCLUSION: PGDM is associated with high risk of neonatal adverse outcomes in infants born premature.