A Study of the Complications in Infants of Diabetic Mothers

Introduction: Diabetes Mellitus is a group of metabolic diseases characterized by chronic hyperglycemia associated with disturbances of carbohydrate, fat and protein metabolism due to absolute or relative deficiency in insulin secretion and or action. The complications in IDMs was studied and a comparison was made between babies born to mothers with pregestational diabetes and gestational diabetes. Objectives: The morbidities in IDMs was studied and a comparison was made between infants born to women with pregestational diabetes and gestational diabetes. Their perinatal outcome was also studied. Methods: All consecutive live born babies born to diabetic mothers were included in the study. IDMs were evaluated for morbidities like macrosomia, birth asphyxia, congenital anomalies, birth injuries, respiratory distress, hypoglycemia, hypocalcemia, hyperbilirubinemia and polycythemia. The neonatal complications in IDMs born to pregestational and gestational diabetic mothers was compared and data was analyzed. The perinatal outcome of these IDMs was studied. Results: The complications seen in IDMs were LGA (20.6%), birth asphyxia (14.7%), congenital anomalies (32.4%), respiratory distress (33.3%), RDS (6.1%), hypoglycemia (84.8%), hypocalcemia (3%), hyperbilirubinemia (21.2%) and polycythemia (6.1%). Hairy Pinna was observed in 52.9% of IDMs. There were no significant statistical differences in the incidence of complications among Infants born to women with pregestational and gestational diabetes. Complications like LGA, congenital anomalies and hypocalcemia were seen only in women with suboptimal glycemic control. Conclusion: Hypoglycemia is the commonest complication seen in IDMs. The other complications observed in IDMs are macrosomia, birth asphyxia, congenital anomalies, respiratory distress, RDS, hypocalcemia, hyperbilirubinemia and polycythemia. No significant difference is seen in neonatal morbidity profiles of IDMs born to pregestational and gestational diabetic mothers. Glycemic control has an important role in decreasing neonatal complications seen in IDMs. Thus early intervention and management of pregnancies complicated by diabetes with good neonatal care will result in decreased complications in IDMs and also will improve outcome in this high risk population.