Infants of diabetic mothers in neonatal intensive care unit? Is it necessary?

Abstract

Objective: Infants born to diabetic mothers have increased risk of morbidity and mortality compared to babies born to mothers without diabetes. In contrast to decrement in neonatal morbidity and mortality due to glucose regulation during pregnancy, some babies born to diabetic mothers require neonatal intensive care. However, it has been recently reported in some studies that; instead of following babies of diabetic mother in neonatal intensive care, they can be also followed successfully in maternity wards. In this study, morbidity and mortality of babies born to diabetic mothers followed in Neonatal Intensive Care Unit (NICU) were analysed retrospectively and intensive care requirement of these babies was investigated. Material and Methods: The data of 100 infants born to diabetic mothers followed in Neonatal Intensive Care Unit in Ondokuz Mayis University, between 01.01.2003 and 01.01.2010 were analysed retrospectively from patient files and database. The demographic features, maternal data, diagnosis of babies and treatments were recorded. Results: 42% of babies had birth weight >90% percentile, 33% of babies had transient tachypnea of newborn, 2% had respiratory distress syndrome, 35% had hypocalcemia, 22% had hypoglycemia, 3% had hypomagnesemia, 1% polycythemia and 14% had septicemia. Cardiac hypertrophy and congenital anomaly were diagnosed in 32% and 20%, respectively. Two babies had brachial plexus injury, 1 baby had clavicula fracture and 1 baby had grade 1 hypoxic ischemic encephalopathy. Mortality rate was 2%. Conclusion: 69% of infants of diabetic mothers followed in NICU had at least one of the problems of respiratory distress syndrome, transient tachypnea of newborn, sepsis, hypocalcemia and hypoglycemia. 15% of babies were hospitalized after their first 24 hours, 40% of these babies were inborn. The problems of infants of diabetic mothers are not exclusively limited to first days. As a result, it can be concluded that the birth and follow-up of these babies should preferentially be in neonatal units at least having level 2 facilities. Copyright © 2011 by Türkiye Klinikleri.