Impact of Maternal Diabetes on Outcomes in Very Preterm, Very Low-Birth-Weight Infants
Risk for preterm delivery is increased in women with diabetes.
Diabetes during pregnancy, though posing a risk for very preterm birth, does not increase the risk for in-hospital mortality or severe morbidity for infants born between 24 and 31 weeks of gestational age and weighing <1500 g, according to a study recently published in JAMA Pediatrics.
This retrospective study analyzed the relationship between mothers who were diagnosed with diabetes and in-hospital mortality and severe neonatal morbidity of their infants. Included neonatal morbidities were intraventricular hemorrhage, cystic periventricular leukomalacia, retinopathy of prematurity, and bronchopulmonary dysplasia, among others. The researchers evaluated infants born between 24 and 31 weeks of gestational age and weighing <1500 g at birth. Infants were grouped into 2 cohorts: those born to mothers diagnosed with either pregestational or gestational diabetes (n=3280) and those born to mothers not diagnosed with diabetes (n=73,080).
The results of the study concluded that preterm infants born to mothers diagnosed with diabetes had a significantly higher birth weight (1081 g vs 1027 g; P<.01) and a later gestational age of 28 to 31 weeks' gestation (65.4% v 55.6%, P<.01); they were also less likely to be born before 28 weeks (34.6 vs 44.4%, P<.01). There was no significant difference between the 2 cohorts for in-hospital mortality and severe neonatal morbidity. These results were reliable between varying countries, gestational ages, sexes, and diagnostic protocols.
A limitation of this study is that the data were drawn from medical networks within high-resource countries; additional research is warranted to assess the impact of maternal diabetes on infant outcomes in countries where resources are limited.
The researchers conclude that infants born between 24 and 31 weeks of gestational age and weighing <1500 g to mothers with diabetes appear to have similar outcomes as those born to mothers without diabetes.
Persson M, Shah PS, Rusconi F, et al; for the International Network for Evaluating Outcomes of Neonates. Association of maternal diabetes with neonatal outcomes of very preterm and very low-birth-weight infants: An international cohort study [published online July 2, 2018]. JAMA Pediatr. doi:10.1001/jamapediatrics.2018.1811