Incidence of hypoglycaemia in late preterm and term infants born to women with diabetes mellitus

Abstract

Background. Diabetes mellitus (DM) is a common metabolic disorder affecting pregnant women and is associated with adverse outcomes in their offspring, including hypoglycaemia. The incidence and factors associated with development of hypoglycaemia in infants of diabetic mothers (IDM) from developing countries such as South Africa are not well known.

Objectives. To determine the incidence of hypoglycaemia and factors associated with its development in IDM.

Methods. Medical records of mothers diagnosed with DM, and their infants who were term and/or late preterm and admitted to the neonatal unit at Chris Hani Baragwanath Academic Hospital, were retrieved and reviewed. Maternal characteristics, type and management of diabetes, infant characteristics and glucose measurements were captured for analysis.

Results. Over the 2-year period, 234 infants were born to diabetic mothers (median age 33 years) and 207 met the diagnostic criteria and were admitted for monitoring of blood glucose using the hemoglucotest. Among the mothers with DM, 56% had gestational diabetes; ~19% of IDM were large for gestational age (LGA) and 10% were macrosomic. Hypoglycaemia occurred in 39% of IDM, and 85% of the infants were diagnosed within the first 6 hours of life. There were no statistically significant differences in maternal characteristics, including type of maternal diabetes and its management between hypoglycaemic and normoglycaemic infants. Hypoglycaemic infants were more likely to be LGA (28.2% v. 12.8%; p=0.009).

Conclusion. Hypoglycaemia is a common finding in IDM. It presents early (within the first 6 hours of life) and rarely beyond 24 hours after birth. The only characteristic found to be associated with development of hypoglycaemia in IDM was a neonate being LGA.