Metabolic and hematological abnormalities in infants of diabetic mothers in the neonatal period

Dr. K.Umamaheswara Rao; Dr . D.Theja Prathima

Volume : VII, Issue : I, January - 2017

Metabolic and hematological abnormalities in infants of diabetic mothers in the neonatal period

Dr. K. Umamaheswara Rao, Dr . D. Theja Prathima

Abstract :

BACKGROUND: The present study aims to study the metabolic and hematological profile in infants of diabetic mothers in the neonatal period.

METHODOLOGY: 50 neonates born to diabetic mothers were enrolled in the study. Gestational age, birth weight, relevant perinatal history and examination findings were recorded. Blood samples were collected to perform relevant biochemical tests and managed as per unit protocol. Echocardiography and ultrasound abdomen was done routinely in all neonates.

RESULTS: Hyperbilirubinemia (26/50–52%) and hypoglycemia (21/50–42%) were the most common hematologic and metabolic abnormality respectively seen in IDMs. Hypoglycemia was usually asymptomatic, occurred with in first 3 hours of life (P<0.000**) and responded to enteral feeds. Polycythemia was seen in 18% (9/50) and hypocalcemia in 12% (6/50) of neonates. Congenital malformations were seen in 24 %( 12/50) of neonates, of which most of them had congenital heart disease. 6% (3/50) of the babies had suffered birth injuries. There was no significant statistical difference in the incidence of complications among infants born to women with pregestational and gestational diabetes. Complications like macrosomia, hypocalcemia, polycythemia, hyperbilirubinemia, hypoglycemia, congenital anomalies were seen most commonly in women with suboptimal glycemic control.

CONCLUSION:

Hypoglycemia and hyperbilirubinemia remain the most common biochemical and hematological abnormality respectively. Infants of diabetic mother are high risk neonates requiring intensive monitoring but their blood glucose measurements may be limited to initial 3 hours minimising trauma and expense. There are no significant differences in neonatal morbidity profiles of IDMs born to pregestational and gestational diabetic mothers if under optimal glycemic control.