Evaluating Neonatal Morbidity According to Maternal HbA1c in Infants of Diabetic Mother

Kim, Dong Sup; Yoon, Sae Hoon; Lee, Seung Hyun; Yu, Seung Taek; Lee, Chang Woo; Oh, Yeon Kyun

Abstract

PURPOSE
Blood glucose control in diabetic mothers during pregnancy is very important because it can affect fetal and neonatal outcomes. We therefore investigated the clinical outcomes of infants of diabetic mothers in relation to the maternal HbA1c level.
METHODS
The subjects were diabetic mothers and their newborns who were admitted in Wonkwang University Hospital from July 2007 to June 2012. We retrospectively reviewed the medical records of 73 neonates, out of the 128 born to diabetic mothers and investigated neonatal and maternal characteristics based on the differences in maternal HbA1c levels. 55 neonates was excluded because maternal HbA1c was not measured.
RESULTS
The mean time for testing the maternal HbA1c was 30+/-5.0 weeks, and the mean level was 6.7+/-1.4%. The mean birth weight in neonates was 3,094+/-831.6 g and was higher in the group with > or =7% HbA1c than in the group with < or =6.4% HbA1c (3,370+/-950.8 g vs. 2,855+/-661.97 g, P=0.0113). When assessing neonatal morbidity, the rates of hypoglycemia (56.0% vs. 28.6%, P=0.0381), large baby (36.0% vs. 4.8%, P=0.0015) and congenital heart disease (CHD) (28% vs. 0%, P=0.0055) were higher in the group with > or =7% HbA1c than in those with < or =6.4% HbA1c. Serum blood sugar level was significantly lower in the group with > or =7% HbA1c than those with < or =6.4% HbA1c (26.5+/-10.5 vs. 35.9+/-8.3 mg/dL, P=0.0196). When considering the rate of large babies (> or =4,000g), there were no differences in birth weights between both groups.
CONCLUSION
If the maternal HbA1c level during pregnancy is above 7% with glucose control failure, infants born to diabetic mothers are susceptible to hypoglycemia, large baby syndrome and CHD.