Abstract
BackgroundInfants born to diabetic women have certain distinctive characteristics, including large size and high morbidity risks. The neonatal mortality rate is over five times that of infants of non diabetic mothers and is higher at all gestational ages and birth weight for gestational age (GA) categories.The study aimed to determine morbidity and mortality pattern amongst infants of diabetic mothers (IDMS) admitted into the Special Care Baby Unit of University of Port Harcourt Teaching Hospital.MethodsThis was a study of prevalence of morbidity and mortality among IDMs carried out prospectively over a two year period. All IDMs (pregestational and gestational) admitted into the Unit within the period were recruited into the study.Data on delivery mode, GA, birth weight, other associated morbidities, investigation results, treatment, duration of hospital stay and outcome were collated and compared with those of infants of non diabetic mothers matched for GA and birth weight admitted within the same period. Maternal data were reviewed retrospectively. Data were analyzed using SPSS 16.0.ResultsSixty percent of the IDMs were born to mothers with gestational diabetes, while 40% were born to mothers with pregestational DM. 38 (74.3%) were born by Caesarian section (CS), of which 20 (52.6%) were by emergency CS. There was no significant difference in emergency CS rates, when compared with controls, but non-IDMs were more likely to be delivered vaginally. The mean GA of IDMs was 37.84 weeks ± 1.88. 29 (61.7%) of them were macrosomic. The commonest morbidities were Hypoglycemia (significantly higher in IDMs than non-IDMs) and hyperbilirubinaemia in 30 (63.8%) and 26 (57.4%) respectively.There was no difference in morbidity pattern between infants of pre- gestational and gestational diabetic mothers. Mortality rate was not significantly higher in IDMsConclusionsThe incidence of macrosomia in IDMs was high but high rates of emergency CS was not peculiar to them. Hypoglycaemia and hyperbilirubinaemia were the commonest morbidities in IDMs.Referring women with unstable metabolic control to specialized centers improves pre- and post- natal outcomes. Maternal-Infant centers for management of diabetes in pregnancy are advocated on a national scale to reduce associated morbidity and mortality
Highlights
Infants born to diabetic women have certain distinctive characteristics, including large size and high morbidity risks
For each IDM, an infant of a non diabetic mother admitted into the unit within the same period, matched for gestational age, and birth weight was recruited as control
Some of the variation in incidence may be related to definition, most authors agree that macrosomia is in part related to maternal glucose control [15,16]
Summary
Infants born to diabetic women have certain distinctive characteristics, including large size and high morbidity risks. The neonatal mortality rate is over five times that of infants of non diabetic mothers and is higher at all gestational ages and birth weight for gestational age (GA) categories. Diabetes has long been associated with maternal and perinatal morbidity and mortality [1]. In a study in Nigeria; an incidence of 1.7% was recorded with pregestational diabetes accounting for 39% and gestational diabetes for 61% [4]. Perinatal mortality amongst offspring of diabetic mothers has remained high and was previously an indication for termination of pregnancy. Studies have shown higher mortality amongst infants of diabetic mothers compared to controls [1,4,6]. In the study in Nigeria, the perinatal mortality was found to be 12.5% compared to 3.5% in controls [4]. Perinatal outcome associated with poor glycaemic control in mothers is associated with as high as 49.2% mortality [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
