Birth Weight Pattern and Immediate Morbidities in 452 Neonates Born to Diabetic Mothers: A Tertiary Centre Perspective

Abstract

Introduction: Neonates born to diabetic mothers continue to remain as highrisk neonates despite advanced care of gestational diabetes mellitus (GDM). Morbidities including macrosomia remain a significant problem. We aimed to study the birth weight pattern, incidence of hypoglycemia and immediate morbidities in neonates born to diabetic mothers.

Methods: Neonates born to diabetic mothers were prospectively studied over 18 months. The birth weight pattern, hypoglycemia, biochemical abnormalities, hyperbilirubinemia and other systemic morbidities were studied.

Results: Among 4654 live births, 516 (11%) neonates were born to diabetic mothers. After excluding 64, 452 neonates were further studied. Overall, 76.1% had normal birth weight. Large for gestational age (LGA) was found in 46 (10.2%). Small for gestational age (SGA) was found in 2.9%. Among 320 neonates born to GDM mothers on diet, 8 (2.5%) were SGA and 32 (10%) were LGA. Among 78 neonates born to GDM mothers on oral hypoglycemic agents, 2 (2.6%) were SGA and 12 (15.4%) were LGA. In 54 neonates born to GDM mothers on insulin, 3 (5.6%) were SGA and 2 (3.7%) were LGA. Overall, 21.7% had one or other morbidity. The overall incidence of hypoglycemia was 15.9%. Hyperbilirubinemia (34.5%) and congenital heart defects (31.8%) were the common morbidities. The other immediate morbidities included respiratory morbidities (9.7%), sepsis (3.8%), polycythemia (2%), birth injuries (1.7%) and perinatal asphyxia (0.9%).

Conclusion: About 10% of neonates born to diabetic mothers have macrosomia. Macrosomia was found more in neonates born to GDM mothers who were on oral glycemic agents than those on insulin. Glucose monitoring is needed in neonates of GDM mothers to detect hypoglycemia early