Hypoglycemia rates in the first days of life among term infants born to diabetic mothers.
OBJECTIVE
To discover the risk factors for developing hypoglycemia in newborns born to diabetic mothers and to characterize the rates of glucose concentrations in the first two days of life.


METHODS
Retrospective recordings of medical charts of 576 healthy term infants of diabetic mothers during an 18-month period. We determined the following pre-feeding glucose concentrations: 'normoglycemia' (> or =47 mg/dl = 2.6 mmol/l), 'mild hypoglycemia' (40-46 mg/dl = 2.2- 2.5 mmol/l), 'moderate hypoglycemia' (30-39 mg/dl = 1.7-2.1 mmol/l) and 'severe hypoglycemia' (<30 mg/dl = 1.7 mmol/l).


RESULTS
Glucose concentrations below 'normoglycemia' and 'severe hypoglycemia' were observed in 280 (48.6%) and 23 (4%) of the infants, respectively. The main risk factors for developing glucose concentrations below 'normoglycemia' in the first day of life were large size for gestational age and maternal insulin-dependent diabetes mellitus. 'Severe hypoglycemia' was more common among infants born to mothers who needed insulin (either type A2 or insulin-dependent diabetes mellitus). Infants born to mothers with insulin-dependent diabetes mellitus were less mature, heavier, large for their gestational age and exhibited more 'severe and moderate hypoglycemia' in the first day of life as compared to infants born to diabetes type A1 and A2 mothers. In addition, infants who were large for gestational age tended to have more 'moderate hypoglycemia' when born to diabetes type A1 mothers compared to small and appropriate-for-gestational-age infants. Thirty infants (5%) still had hypoglycemia on the second day of life. This subgroup of infants did not differ with regard to maternal-type diabetes.


CONCLUSIONS
Infants born to diabetic mothers tend to have a high rate of hypoglycemia on the first day of life when a relatively high cut-off point (> or =47 mg/dl = 2.6 mmol/l) is used. Infants born large for gestational age as well as those born to mothers with juvenile diabetes mellitus are at higher risk and should be closely monitored.
Maayan-Metzger
Ayala
A
Department of Neonatology, The Edmond and Lili Safra Children's Hospital, Sheba Medical Center, Ramat Gan and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. maayan@post.tau.ac.il
Lubin
Daniel
D
Kuint
Jacob
J
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1; D003924:Diabetes Mellitus, Type 2; D005260:Female; D005320:Fetal Macrosomia / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D005865:Gestational Age; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
D001786:Blood Glucose