[Perinatal complications in newborns of mothers with gestational diabetes].
OBJECTIVE
To determine how metabolic monitoring of women with gestational diabetes influences the morbidity of newborns.


METHODS
Retrospective study.


METHODS
352 newborns of mothers with gestational diabetes. 295 mothers suffered from diabetes class G1 (G1DM) and 57 from diabetes class G2 (G2DM).


METHODS
Glycated haemoglobin levels measured at the moment of the diagnosis of gestational diabetes and shortly before delivery were higher in women with diabetes type G2, but the difference was statistically significant only at the first measurement (G1 6.1+/-1,5% vs. G2 6.7+/- 1.6%, p<0.01). Mean gestational age at the time of delivery in the whole group was 38 +/- 2 hbd and there was not any difference between newborns of mothers with G1DM and G2DM. Mean birth weight in newborns of G1DM mothers was 3390 +/- 620 g and in newborns ofG2DM mothers it was 3330 +/- 720 g (NS).


RESULTS
31 (8.8%) infants were large for gestational age (LGA) and 20 (5.7%) infants were small for gestational age (SGA). There was not any difference between newborns of mothers with diabetes class G1 and G2 in the incidence of LGA and SGA. Neither there was any difference between these two groups in the incidence of metabolic disorders (hypoglycemia, hypocalcaemia. hypomagnesaemia. hyperbilirubinemia) and other pathologic conditions (respiratory distress syndrome (RDS), polycythemia, hypertrophic cardiomyopathy and perinatal infections). The incidence of congenital malformations was similar in both groups. LGA newborns were statistically more often newborns of mothers with HbA1c level exceeding the normal value (HbA1c>6.3%). This correlation was observed both in the first measurement of HbA l c and the measurement performed shortly before delivery. In LGA newborns we observed hypoglycemia, polycythemia and hypertrophic cardiomyopathy more often. Perinatal infections appeared statistically more often in the SGA newborns. 31.25% infants from the study group were born before the end of the 37th week of gestation. These newborns more often suffered from RDS, hypoglycemia, hyperbilirubinemia and perinatal infections.


CONCLUSIONS
There was not any significant difference in neonatal outcome in newborns of mothers with gestational diabetes class G1 and G2. This might have resulted from the fact that there was neither any statistically significant difference between these two groups in HbA1c level measured shortly before delivery. The incidence of metabolic disorders in newborns was correlated with LGA, SGA and prematurity, but there was not any difference in the occurrence of metabolic disorders between newborns of mothers with G1DM and G2DM.
Wróblewska-Seniuk
Katarzyna
K
Klinika Zakazeń Noworodka, Akademia Medyczna im. K. Marcinkowskiego, Polna 33, 60-535 Poznań, Poland.
Wender-Ozegowska
Ewa
E
Szczapa
Jerzy
J
Chojnacka
Karolina
K
Biegańska
Ewa
E
Pietryga
Marek
M
Biczysko
Romuald
R
Gadzinowski
Janusz
J
D000328:Adult; D015984:Causality; D015897:Comorbidity; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology*; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D018743:Perinatal Care / Q000458:organization & administration*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies
D006442:Glycated Hemoglobin