Infants of diabetic mothers: maternal and infant characteristics and incidence of hypoglcemia
Date
2016
Authors
Magadla, Yoliswa
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Abstract
Background: Diabetes mellitus is the most common metabolic disease affecting women
during pregnancy and is associated with adverse outcomes during the neonatal period,
common one being hypoglycemia. The characteristics and incidence of hypoglycemia in
infants of diabetic mothers (IDM) are not well reported in South Africa.
Objectives: To describe the characteristics of IDM with or without hypoglycemia and to
determine prevalence of hypoglycemia in IDM.
Methods: Medical records of mothers, and their infants admitted with a diagnosis of IDM
at gestational age ≥34 weeks and/ or birth weight ≥2000 grams and admitted at CHBAH
from January 2012 to December 2013, were retrieved. Maternal characteristics, type and
treatment of diabetes, infant characteristics and glucose measurements were captured for
analysis.
Results: A total of 234 IDM were admitted over this 2-year period and 207 met inclusion
criteria. Median maternal age was 33 years. Seven percent of mothers had stillbirths and
14% had miscarriages in previous pregnancies. A total of 56% of mothers had gestational
diabetes. Among infants, 54% were born preterm, 19% were large for gestational age
(LGA) and 10% were macrosomic. Pre-gestational diabetic mothers had higher preterm
births than gestational diabetic mothers (64% vs 48%, p=0.037). Hypoglycemia occurred
in 39% of IDM, occurring within the first 3 hours of life in 85% of infants. There were no
statistically significant differences in types of maternal diabetes and its treatment between
hypoglycaemic and normoglycaemic infants, but hypoglycaemic infants were more likely
to be LGA (28.2% vs 12.8%, p=0.009).
Conclusion: Hypoglycemia is a common finding in IDM, presenting early in postnatal
age. Only just over a quarter of hypoglycaemic infants are LGA. All IDM should be
monitored for hypoglycemia, especially within the first 3 hours of life.
Description
A dissertation submitted to the faculty of Health Sciences, University of the
Witwatersrand, in fulfillment of the requirements for the degree of Masters in Medicine.
Johannesburg 2016
Keywords
Diabetic Mothers