Morbidity In Infants of Diabetic Mothers

OBJECTIVE: To investigate problems of infants of diabetic mothers who are born in our hospital and then treated in NICU during newborn period because of their clinical problems.
METHODS: The study is based on the 82 infants of Diabetic mothers who were born in İstanbul Bakırköy Maternity and Children Hospital between 1st January 2008 and 1 st January 2009 and also were treated in NICU because of their clinical problems in the newborn period. The documents of the patients were analyzed retrospectively.The study report which includes the mother’s data (type of Diabetes, medications, smoking and presence of chronic disease) and the newborns’ data (birth weight, type of delivery, 1st and 5th second APGAR scores, sex and clinical problems such as RDS, TTN, MAS, septisemia, hypocalcemia, hypomagnesemia, hypoglycemia, polistemia, hyperbilirubinemia, birth injuries, congenital malformations, congenital heart diseases) was formed. The data were analyzed statistically.
RESULTS: The distribution of 82 cases according to their types of mother diabetes were as following; the mothers of 2 (2%) newborns were type 1 DM, the mothers of 4 (5%) newborns were Type 2 DM and the mothers of 76 (93%) newborns were Gestational DM.The 31(38%) of newborns were female, 51(62%) of newborns were male.The birth weights of 6 (7% ) cases were under 2500 gr (SGA), 39 (47% ) of the cases were over 4000 gr (LGA) and the birth weights of other 37 (45%) cases were 2500-4000 gr (AGA). The most frequently seen newborn period clinical problems were; hyperbilirubinemia in 33 cases, hypoglycemia in 29 cases,congenital heart diseases in 28 cases. The most frequently observed echocardiography findings were Hypertrophic CMP, ASD, and PDA.The average hospitalization period of cases were 7,9±5,5 days.
CONCLUSION: Several problems may occur, such as hyperbilirubinemia, hypoglycemia and congenital cardiac disorders in infants diagnosed with infant of diabetic mother. To reduce the possibility of morbidity and mortality, it is recommended that these infants should be followed closely during their prenatal, natal and postnatal periods.

Diabetik Anne Çocuklarında Morbidite

AMAÇ: Hastanemiz yenidoğan ünitesinde izlenen term diyabetik anne çocuklarının değerlendirilmesi
YÖNTEMLER: Bakırköy Kadın Doğum ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi’nde 1 Ocak 2008 – 1 Ocak 2009 tarihleri arasında yenidoğan servisinde izlenen 82 term diabetik anne çocuğunun dosyaları retrospektif olarak incelendi. Olguların anne bilgileri (annenin diabet durumu, kullandığı ilaçlar, sigara içimi, kronik hastalık durumu), bebeklerin doğum ağırlığı, doğum şekli, 1. ve 5. dakika APGAR skoru, cinsiyet ve bebeğin hastanede yattığı dönemde ortaya çıkan sorunları (RDS, TTN, MAS, sepsis, hipokalsemi, hipomagnezemi, hipoglisemi, polistemi, hiperbilirubinemi, doğum travması, konjenital malformasyonlar ve konjenital kalp hastalığı ) kaydedildi.
BULGULAR: 82 olgunun; 2’si (%2) Tip 1 DM’lu anne bebeği, 4’ü(%5) Tip 2 DM’lu anne bebeği, 76’sı (%93) gestasyonel diyabetli anne çocuğu olup, olguların 31’i (%38) kız, 51’i (% 62) erkekti. Yirmi dokuzu NSD, 53’ü C/S ile doğan olguların 6’sı (%7 ) SGA, 37’si (% 45) AGA, 39’u (% 47) LGA bebekti. En sık saptanan sorunlar 33 (%40.8) olgu ile hiperbilirubinemi, 29 (% 35) olgu ile hipoglisemi ve 28 (% 34.1) olgu ile konjenital kalp hastalığıydı. Yapılan ekokardiyografilerde ise en sık rastlanan anomaliler hipertrofik KMP, ASD, ve PDA olarak saptandı.
SONUÇ: DAÇ tanısı alan bebeklerde başta hiperbilirubinemi, hipoglisemi ve konjenital kalp hastalıkları olmak üzere pek çok sorun ortaya çıkabilir. Olası morbidite ve mortaliteyi azaltmak için bu bebekler prenatal, natal ve postnatal dönemlerde yakından takip edilmelidir.