title: Perinatal outcome of infants born to diabetic mothers in a developing country--comparison of insulin and oral hypoglycemic agents.
abstract: OBJECTIVE
  To study the perinatal outcomes of infants born to mothers with gestational diabetes treated with insulin or oral hypoglycemic agents in a developing country.
  
  
  METHODS
  Prospective observational cohort study.
  
  
  METHODS
  Tertiary-care perinatal center in southern India.
  
  
  METHODS
  Babies born to mothers with gestational diabetes.
  
  
  METHODS
  Maternal details were obtained and physical examination was performed on the neonates. Babies were given hourly feeds soon after birth and blood glucoses checked at 1, 3, 5, 9 and 12 hours of life; hematocrit and calcium levels were also measured. Perinatal outcomes were compared between mothers who required insulin or an oral hypoglycemic agent for treatment of diabetes.
  
  
  RESULTS
  Of the 10,394 mothers who delivered during the study period, 574 (5.5%) were diagnosed to have gestational diabetes. 137 were treated with insulin and 141 with oral hypoglycemic agents. 44 (15.8%) babies were born preterm, 97 (35%) were large for gestational age, 13 (4.7%) were small for gestational age and 9 (3.2%) were macrosomic. Hypoglycemia was seen in 26 (9.3%) babies, congenital anomalies in 15 (5.4%) and birth injuries in 7 (2.5%). There was no difference between the two groups in any of the outcomes except for hyperbilirubinemia, which was more in the insulin group (13.7% vs 6.5%, P=0.04).
  
  
  CONCLUSIONS
  There was no difference in the perinatal outcome whether the mother received insulin or an oral hypoglycemic agent for treatment of gestational diabetes other than the increased incidence of hyperbilirubinemia in the insulin group.
authors.affiliation: Department of Neonatology, Christian Medical College, Vellore 632 004, Tamil Nadu, India. niranjan@cmcvellore.ac.in
authors.forename: Niranjan
authors.initials: N
authors.lastname: Thomas
authors.forename: Annie Jothirmayi
authors.initials: AJ
authors.lastname: Chinta
authors.forename: Santhanam
authors.initials: S
authors.lastname: Sridhar
authors.forename: Manish
authors.initials: M
authors.lastname: Kumar
authors.forename: Kurien Anil
authors.initials: KA
authors.lastname: Kuruvilla
authors.forename: Atanu Kumar
authors.initials: AK
authors.lastname: Jana
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood / Q000188:drug therapy*; D007328:Insulin / Q000627:therapeutic use*; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin