The outcome of pregnancy in diabetic women: II. Analysis of clinical abnormalities and pathologic lesions in offspring of diabetic mothers

Abstract

In addition to an increased fetal loss and high perinatal mortality, the offspring of diabetic mothers also have an increased risk of morbidity as compared to the normal controls. Of 157 pregnancies in 48 diabetic women, 6 offspring were abnormal. This constitutes an incidence of 3.8 per cent of all pregnancies and 7.6 per cent of the 79 surviving children. In the matched controls the abnormal surviving offspring constituted only 0.4 per cent of 249 pregnancies. Three of the 6 abnormal surviving children born to diabetic mothers had severe congenital malformations, 2 had mental deficiencies, and 1 had sequelae of birth injury and epilepsy. Of the 41 offspring of diabetic women who were stillborn or died during the neonatal stage, 16 had comprehensive postmortem examination at which the following findings were observed: pulmonary hyaline membrane disease in 8 patients; congenital malformations in 3; cerebral birth injury in 2; and no gross, demonstrable lesion in the remaining 3. Factors possibly pertaining to the increased fetal loss and to the higher rate of morbidity among the offspring of diabetic mothers are discussed. In addition to an increased fetal loss and high perinatal mortality, the offspring of diabetic mothers also have an increased risk of morbidity as compared to the normal controls. Of 157 pregnancies in 48 diabetic women, 6 offspring were abnormal. This constitutes an incidence of 3.8 per cent of all pregnancies and 7.6 per cent of the 79 surviving children. In the matched controls the abnormal surviving offspring constituted only 0.4 per cent of 249 pregnancies. Three of the 6 abnormal surviving children born to diabetic mothers had severe congenital malformations, 2 had mental deficiencies, and 1 had sequelae of birth injury and epilepsy. Of the 41 offspring of diabetic women who were stillborn or died during the neonatal stage, 16 had comprehensive postmortem examination at which the following findings were observed: pulmonary hyaline membrane disease in 8 patients; congenital malformations in 3; cerebral birth injury in 2; and no gross, demonstrable lesion in the remaining 3. Factors possibly pertaining to the increased fetal loss and to the higher rate of morbidity among the offspring of diabetic mothers are discussed.