Neonatal Glycemic Status of Infants of Diabetic Mothers in a Tertiary Care Hospital

Maternal and Neonatal Outcomes of Pregnant Women with Abnormal 50 g Glucose Challenge Tests in Nakhon Si Thammarat, Thailand: A Retrospective Study

(1) Background: An abnormal 50 g glucose challenge test (50 g GCT) during pregnancy, even without a diagnosis of gestational diabetes mellitus (GDM), may result in undesirable obstetric and neonatal outcomes. This study sought to evaluate the outcomes in pregnant women with abnormal 50 g GCT in secondary care hospitals in Thailand. (2) Methods: A total of 1129 cases of pregnant women with abnormal 50 g GCT results who delivered between January 2018 and December 2020 at Thasala, Sichon, and Thungsong hospitals were retrospectively reviewed and divided into three groups: abnormal 50 g GCT and normal 100 g oral OGTT (Group 1; n = 397 cases), abnormal 50 g GCT and one abnormal 100 g OGTT value (Group 2; n = 452 cases), and GDM (Group 3; n = 307 cases). (3) Results: Cesarean section rates in group 3 (61.9%) were statistically higher than those in groups 1 (43.6%) and 2 (49.4%) (p < 0.001). In addition, the highest rate of birth asphyxia was found in group 2 (5.9%), which was significantly higher than that in Groups 1 (1.8%) and 3 (3.3%) (p = 0.007). (4) Conclusions: Pregnant women with abnormal 50 g GCTs without a diagnosis of GDM had undesirable maternal and neonatal outcomes, as well as those who had GDM, suggesting that healthcare providers should closely monitor them throughout pregnancy and the postpartum period.

Hypoglycemia and associated comorbidities among newborns of mothers with diabetes in an academic tertiary care center

Background

Hypoglycemia is considered the common metabolic problem in newborns with serious long-term sequelae. This study evaluates the incidence of hypoglycemia in the newborns of mothers with diabetes mellitus and assesses the comorbidities that affect the newborns of mothers with gestational diabetes compared with the newborns of mothers with pregestational diabetes mellitus.

Methods

This retrospective cohort study was conducted between January-2018 and December-2020. All admissions to the hospital nursery of the newborns of diabetic mothers with diabetes mellitus were included.

Results

The study comprised 1,036 mothers with diabetes, of the newborns of mothers with pregestational diabetes, 22% had hypoglycemia, and of mothers with gestational diabetes, 12%. Mothers with pregestational diabetes had a significantly higher risk of needing an emergency cesarean section (OR: 2.1, 95% CI: 1.3-3.4); and of having a baby who is large for its gestational age (OR: 9.5, 95% CI: 2.6-35.5), must be admitted to the NICU (OR: 2.9, 95% CI: 1.5-5.6), has respiratory distress syndrome (OR: 3.3, 95% CI: 1.5-7.4), and needs gavage feeding (OR: 3.5, 95% CI: 1.4-8.9).

Conclusion

About 13% of the newborns of mothers with diabetes had hypoglycemia. Significantly more of these newborns were of mothers with pregestational diabetes than of mothers with gestational diabetes. Newborn of mothers with pregestational diabetes mellitus have the risk of large weight and neurological problems, such as sucking difficulties, length of hospital stay, NICU admission, and respiratory distress syndrome.

The risk of morbidities in newborns of antenatal vitamin D supplemented gestational diabetes mellitus patients

BACKGROUND

There is no established antenatal intervention that reduces the risk of preeclampsia and preterm delivery in gestational diabetes mellitus (GDM) mothers and hyperbilirubinemia, hypoglycemia, and hospitalization in their newborns. Henceforth, this study aims to study how these risks change on prenatal vitamin D supplementation.

METHODS

Randomized parallel arm trials comparing these interventions' effect on the above outcomes were searched in the PubMed, Embase, and Scopus, irrespective date, and language of publication. Each eligible trial's risk of bias was assessed using the Cochrane collaboration tool. Using random-effects meta-analysis, the risk of the outcomes was compared.

RESULTS

Six eligible Iran-based trials of about 476 participants were included in this review. Four trials complemented vitamin D along with other nutrients. Overall, the risk of bias was low in these trials. The newborns of antenatal vitamin D recipients have a reduced risk of hyperbilirubinemia (relative risk [RR] = 0.46; 95% confidence interval [CI]: 0.33, 0.64; I² = 0%) and hospitalization (RR = 0.46; 95% CI: 0.32, 0.65; I² = 0%) than those who did not receive the supplement. The rest of the outcomes did not vary between the compared interventions. The results remained unchanged on using a fixed-effect meta-analysis, repeating the meta-analysis while eliminating a trial each time, and on imputation analysis. An auxiliary meta-analysis comparing the intervention with placebo also suggested a decreased risk of hyperbilirubinemia (RR = 0.43; 95% CI: 0.30, 0.62; I² = 0%) and hospitalization (RR = 0.44; 95% CI: 0.30, 0.62; I² = 0%).

CONCLUSION

Newborns of GDM mothers who received vitamin D as a sole or co-supplement antenatally have a decreased risk of hyperbilirubinemia and hospitalization.