Analysis of outcomes in neonates of mothers with gestational diabetes mellitus at a tertiary care hospital in Goa

R. Naik, G. Pednekar, J. Cacodcar
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Abstract

Background: Diabetes is a common metabolic disorder complicating pregnancy in India. Babies born to diabetic mothers are at increased risk of neonatal complications as well as long term complications with potential of developing type 2 DM in future. Methods: A large prospective study was conducted at a tertiary care hospital in Goa for a period of 18 months (2014-2016) to study the outcomes among neonates born to mothers with Gestational Diabetes Mellitus (GDM). Results: Clinical outcomes of neonates born to 424 mothers with GDM were studied and compared with 424 neonates born to mothers without GDM during the same time period. The mean birth weight of neonates born to GDM mothers was 3.17 kg. Macrosomia was found among 1.2% neonates born to GDM mothers. There was no significant difference in Apgar scores at 5 minutes of birth in GDM and non-GDM groups. The rate of admissions to Neonatal Care Unit was significantly higher (32.1%) in neonates born to GDM mother as compared to non-GDM group. Incidence of neonatal complications like respiratory distress syndrome (4.2%) and hypoglycaemia (11%) was significantly higher in neonates born to GDM mothers. There was a significant increase noted in neonatal mortality (3.3%) in the GDM group. Conclusion: Numerous complications are reported among neonates born to mothers with GDM. Hence these mothers with GDM should be delivered in tertiary care centre or district hospitals where fully staffed and well equipped neonatal intensive care units are available for management of these complications.
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果阿邦一家三级医院妊娠期糖尿病母亲的新生儿结局分析
背景:糖尿病是印度妊娠期常见的代谢性疾病。糖尿病母亲所生的婴儿患新生儿并发症的风险增加,长期并发症也有可能在未来发展为2型糖尿病。方法:在果阿邦一家三级医院进行了一项为期18个月(2014-2016)的大型前瞻性研究,研究妊娠期糖尿病(GDM)母亲所生新生儿的结局。结果:研究了424名GDM母亲所生新生儿的临床结果,并与同期424名无GDM母亲所生新生儿进行了比较。GDM母亲所生新生儿的平均出生体重为3.17 kg。在GDM母亲所生的新生儿中,有1.2%存在巨大儿。GDM组和非GDM组出生5分钟时Apgar评分无显著差异。GDM母亲所生的新生儿入院率(32.1%)明显高于非GDM母亲所生的新生儿。新生儿并发症如呼吸窘迫综合征(4.2%)和低血糖(11%)的发生率在GDM母亲所生的新生儿中明显更高。GDM组新生儿死亡率显著增加(3.3%)。结论:GDM母亲所生的新生儿有许多并发症。因此,这些患有GDM的母亲应该在三级保健中心或地区医院分娩,因为这些医院配备了充分的人员和设备齐全的新生儿重症监护病房,可以管理这些并发症。
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