AI Summary & Key Takeaways
AI InsightTo reduce the possibility of morbidity and mortality, it is recommended that these infants should be monitored closely during their prenatal, natal and postnatal periods.
📌 3 Key Takeaways
Abstract
Objective: To investigate problems of infants of diabetic mothers who are born in our hospital and then monitored in NICU. Material and Methods: This study retrospectively analyzed files of 82 infants of diabetic mothers who were followed-up in İstanbul Bakırköy Maternity and Children’s Hospital between January 1st 2008 and January 1st 2009. Some demographic data related to mothers (type of diabetes, medications, smoking status, and presence of chronic disease) and the newborns (birth weight, type of delivery, 1st and 5th minute-APGAR scores, sex and clinical problems such as RDS, TTN, MAS, septisemia, hypocalcemia, hypomagnesemia, hypoglycemia, polycytemia, hyperbilirubinemia, birth injuries, congenital malformations, congenital heart diseases were recorded. Findings: Distribution of 82 newborns according to their mothers’ type of diabetes were as follows; the mothers of 2 (2 %) newborns were type 1 DM, of 4 (5 %) Type 2 DM, and of 76 (93 %) were gestational DM. Thirty one (38 %) newborns were female and 51 (62 %) were male. The birth weights of 6 (7 %) cases were under 2500 gr (small for gestational age [SGA]), and 39 (47 %) over 4000 gr (large for gestational age [LGA]), while the remaining 37 (45 %) newborns weighed between 2500-4000 gr (appropriate for gestational age [AGA]). The most frequently found clinical problems during the newborn period were; hyperbilirubinemia in 33, hypoglycemia in 29, and congenital heart diseases in 28 cases, respectively. The most frequently observed echocardiographic findings were hypertrophic cardiomyopathy (CMP), atrial septal defect (ASD), and tatent ductus arteriosus (PDA). The average hospitalization period of cases was 7.9±5.5 days. Conclusion: Several problems may emerge such as hyperbilirubinemia, hypoglycemia and congenital cardiac disorders in infants diagnosed as infant of a diabetic mother. To reduce the possibility of morbidity and mortality, it is recommended that these infants should be monitored closely during their prenatal, natal and postnatal periods.
Özet
Amaç: Hastanemiz yenidoğan ünitesinde izlenen term diyabetik anne çocuklarının değerlendirilmesi. Gereç ve Yöntem: Bakırköy Kadın Doğum ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi’nde 1 Ocak 2008 - 1 Ocak 2009 tarihleri arasında yenidoğan servisinde izlenen 82 term diyabetik anne çocuğunun dosyaları retrospektif olarak incelendi. Olguların anne bilgileri (annenin diyabet durumu, kullandığı ilaçlar, sigara içimi, kronik hastalık durumu), bebeklerin doğum ağırlığı, doğum şekli, 1. ve 5. dk. 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.