Incidence and risk factors for neonatal hypoglycaemia among women with gestational diabetes mellitus in South Auckland.
OBJECTIVE
To describe the incidence and risk factors for neonatal hypoglycaemia among the offspring of women with gestational diabetes mellitus (GDM) in South Auckland, New Zealand


METHODS
A retrospective audit was undertaken of singleton pregnancies delivered between 1991 and 1994. Data were obtained for 373 women and their deliveries (57 European, 76 Maori, 198 Pacific Islands, 42 other).


RESULTS
Pacific Islands women were most likely to have large babies with neonatal hypoglycaemia in spite of a high use of insulin. Postnatally Maori and Pacific Islands women had a high incidence of Type 2 diabetes mellitus (21.4, 21.7 vs. 4.3% Europeans, 12.0% others, P =0.035). Babies experiencing hypoglycaemia were more likely to have a mother with past GDM (51.2 vs. 27.2%, P = 0.01) and greater hyperglycaemia (at diagnosis fasting 6.8 +/- 1.7 vs. 5.7 +/- 1.1 mmol/l, P < 0.001; finger-prick glucose 5.7 +/- 1.0 vs. 5.2 +/- 0.8 mmol/l, P < 0.001). Macrosomia, Caesarian section and special care baby unit admission were more common in pregnancies complicated by neonatal hypoglycaemia.


CONCLUSIONS
Maternal hyperglycaemia was a major contributing factor to neonatal hypoglycaemia in this population. Undiagnosed Type 2 diabetes was common among Maori and Pacific Islands women, confirming the need for earlier detection and treatment.
Simmons
D
D
Department of Rural Health, University of Melbourne, Shepparton, Victoria, Australia. d.simmons@medicine.unimelb.edu.au
Thompson
C F
CF
Conroy
C
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D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D016640:Diabetes, Gestational / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D007003:Hypoglycemia / Q000453:epidemiology* / Q000209:etiology; D007231:Infant, Newborn; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007751:Labor, Induced; D016015:Logistic Models; D009520:New Zealand; D011114:Polynesia / Q000208:ethnology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D012307:Risk Factors; D015430:Weight Gain
D007328:Insulin