A clinical study on infants of diabetic mothers

Choe, Gyeong; Choi, Young Kwon; Choi, Young Youn; Hwang, Tai Ju

Abstract

Thirty one infants of diabetic mothers(IDM) who had been admitted in Neonatal Intensive Care Unit at Chonnam University Hospital from January 1987 to July 1991 were studied for evaluation of their perinatal outcome and prognosis. The results were as follows; 1) The distribution of diabetic mothers according to modified White's classification was GD & class A in 12 cases(38.7%), B in 16 cases(51.6%), C in one case, D4 in one case, and R in one case. 2) Of the 31 diabetic mothers, 8(25.8%) had a history of infertility or stillbirth, 20(64.5%) had prognostically bad signs of pregnancy (PBSP), and 12(38.7%) were treated with insulin and/or oral hypoglycemic agent during pregnancy. 3) C-section rate was 32.2%, and the rates of shoulder dystocia and birth asphyxia were 35.5% and 29.0%, respectively. 4) The rates of large for gestational age were 75.0% in class GD & A, 68.8% in class B, and the rates of small for gestational age were 8.3% and, 6.3% respectively, Characteristic face with body composition was noted in all babies, hepatosplenomegaly in 90.3%, heart murmur in 41.9%, respiratory distress syndrome in 12.9%, transient tachypnea of mewborn in 19.4%, hypertrophic cardiomyopathy in 40.0%, and seizure in 6.5%. 5) Laboratory abnormalities were hypoglycemia in 77.4%, hyperbilirubinemia in 83.9%, polycythemia in 16.1%, hyperinsulinemia in 45.5%, hypercalcemia in 22.6%, and hypomagnesemia in 23.1%. 6) Birth injuries were noted in 61.3%, The most common were caput succedaneum and/or cephal-hematoma, brachial palsy, and fracture. Congenital anomalies were noted in 16.1%. The most common were musculoskeletal, cardiovascular, and gastrointestinal anomalies. 7) In the short term follow up of 19 patients, there were mild developmental delay in 2 cases, cerebral palsy in 2 cases, and epilepsy in 1 case. These results suggested that infants of diabetic mothers had greater morbidity than infants of nondiabetic mothers. Therefore, long term follow up is recommended to achieve their normal growth and development.