Effect of prenatal care on infants of Diabetic Mellitus mothers

Background:

This study evaluates the frequency of diabetes complication in infants of diabetic mothers (IDMs), and investigates its relationship with patients follow-up care and maternal glucose control.

Material and methods:

Diabetic Mothers who delivered in Ahvaz Imam Khomeini Hospital in 2011 were given questionnaires to gather data on gender of infants, gestational age, type of diabetes (overt versus gestational), birth weight, birth trauma, Apgar score, respiratory distress, neonatal blood glucose, congenital anomalies, LBW and the way the mothers controlled their diabetes (follow-up visits to gynecologist, internist or endocrinologist and maternal glucose control). For each infant of a diabetic mother, one non-diabetic was chosen as a positive control.

Results:

Out of 199 diabetic mothers, 151 (76%) suffered from gestational diabetes and 48 (24%) had overt DM. Low birth weight was present in 35 (18%) of neonates, macrosomia in 22 (11%), neonatal trauma in 10 (5%), respiratory distress in 28 (15%), congenital anomalies in 8 (4%) and hypoglycemia in 63 (32%). Rate of C/S, hypoglycemia, preterm labor and macrosomia were significantly higher in the diabetic group (P: 0.0001, 0.0001, 0.001 and 0.046 respectively). 130 mothers (66%) had regular follow-up visits and 66 (33%) had maternal glucose control, out of whom only 24 (12%) had correct and regular glucose control . Hypoglycemia and congenital anomalies had a significant lower rate in neonates of mothers with a regular visit (P: 0.001and 0.02 respectively). Maternal glucose control leads to significant reduction in the rate of congenital anomalies (P: 0.04).