Morbidities among Very Low Birth Weight and Very Preterm Infants of Diabetic Mothers: A Prospective, Cross-Sectional Study

Authors

  • Dr. Marwa Sameer Al-sheikh (MD, MBChB, CABP), Specialist Pediatrician and Neonatal fellow, Children Welfare Teaching Hospital, Medical City Complex
  • Numan Nafie Hameed Professor, (MD, MBChB, FRCPCH, FIBMS/Ped., DCH), Professor of Pediatrics, Faculty of Medicine, Baghdad University and Consultant Pediatrician, Children Welfare Teaching Hospital, Medical City Complex

Keywords:

Preterm infants, very low birth weight, maternal diabetes, respiratory distress syndrome, bronchopulmonary dysplasia

Abstract

Maternal diabetes, whether chronic or gestational, is linked to a higher likelihood of complications in very low birth weight (VLBW) and very preterm (VPT) newborns. These newborns are especially susceptible to respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and other complications that occur during infancy.

This study aimed to assess the perinatal outcomes of VLBW and VPT infants born to mothers with diabetes. The main goal was to examine the neonatal problems and their correlations with maternal and neonatal variables. This study was a prospective, observational study carried out in the Neonatal Intensive Care Unit (NICU) of Baghdad Teaching Hospital. A cohort of 150 VLBW and VPT neonates whose mothers had diabetes were included. An analysis was conducted on maternal variables, including type of diabetes, hypertension, prenatal steroid use, and mode of delivery, in conjunction with neonatal outcomes such as RDS, BPD, NEC, and intraventricular hemorrhage (IVH). The statistical analysis was conducted using chi-square tests and correlation coefficients.

Among the 150 neonates, an elevated occurrence of RDS (139, 92.7%) and BPD (51, 34%) was seen in VLBW and VPT infants born to mothers with diabetes. The prevalence of NEC was 49 (32.7%), but IVH and severe retinopathy of prematurity (ROP) were less frequent diagnoses. No statistically significant correlations were found between the method of delivery and RDS or between maternal diabetes and neonatal APGAR scores.

Maternal diabetes greatly increases the risk of complications in VLBW and VPT infants. The optimization of maternal glycemic control and the provision of personalized newborn care are crucial for improving outcomes in this high-risk population.

References

1. Abman SH, Allegaert K, Arya B, Askenazi D, Azhibekov T, Back SA, et al. Contributors. Avery’s Diseases of the Newborn. 2018; vii–xx. Elsevier.

2. ‌Magliano DJ, Boyko EJ; IDF Diabetes Atlas 10th edition scientific committee. IDF Diabetes atlas [Internet]. 10th ed. Brussels: International Diabetes Federation; 2021. PMID: 35914061.

3. Hossain MJ, Al-Mamun M, Islam MR. Diabetes mellitus, the fastest growing global public health concern: Early detection should be focused. Health Sci Rep. 2024 Mar 22; 7(3):e2004. doi: 10.1002/hsr2.2004. PMID: 38524769; PMCID: PMC10958528.

4. Fanaroff and Martin’s Neonatal-Perinatal Medicin: 12th edition | Edited by Richard J. Martin | ISBN: 9780323932660 [Internet]. Elsevier.

5. ‌Moon JH, Jang HC. Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications. Diabetes Metab J. 2022 Jan; 46(1):3-14. doi: 10.4093/dmj.2021.0335. Epub 2022 Jan 27. PMID: 35135076; PMCID: PMC8831816.

6. Nakshine VS, Jogdand SD. A Comprehensive Review of Gestational Diabetes Mellitus: Impacts on Maternal Health, Fetal Development, Childhood Outcomes, and Long-Term Treatment Strategies. Cureus. 2023 Oct 23; 15(10):e47500. doi: 10.7759/cureus.47500. PMID: 38021940; PMCID: PMC10663705.

7. Ejaz Z, Azhar Khan A, Sebghat Ullah S, Aamir Hayat M, Maqbool MA, Amin Baig A. The Effects of Gestational Diabetes on Fetus: A Surveillance Study. Cureus. 2023 Feb 17; 15(2):e35103. doi: 10.7759/cureus.35103. PMID: 36938248; PMCID: PMC10023128.

8. Ye W, Luo C, Huang J, Li C, Liu Z, Liu F. Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis. BMJ. 2022 May 25; 377:e067946. doi: 10.1136/bmj-2021-067946. PMID: 35613728; PMCID: PMC9131781.

9. Bapayeva G, Terzic S, Dotlic J, Togyzbayeva K, Bugibaeva U, Mustafinova M, et al. Pregnancy outcomes in women with diabetes mellitus - the impact of diabetes type and treatment. Prz Menopauzalny. 2022 Mar; 21(1):37-46. doi: 10.5114/pm.2022.113781. Epub 2022 Feb 21. PMID: 35388283; PMCID: PMC8966416.

10. Plows JF, Stanley JL, Baker PN, Reynolds CM, Vickers MH. The Pathophysiology of Gestational Diabetes Mellitus. Int J Mol Sci. 2018 Oct 26; 19(11):3342. doi: 10.3390/ijms19113342. PMID: 30373146; PMCID: PMC6274679.

11. Kalikkot Thekkeveedu R, Guaman MC, Shivanna B. Bronchopulmonary dysplasia: A review of pathogenesis and pathophysiology. Respir Med. 2017 Nov; 132: 170-177. doi: 10.1016/j.rmed.2017.10.014. Epub 2017 Oct 24. PMID: 29229093; PMCID: PMC5729938.

12. Hu X, Liang H, Li F, Zhang R, Zhu Y, Zhu X, Xu Y. Necrotizing enterocolitis: current understanding of the prevention and management. Pediatr Surg Int. 2024 Jan 10; 40(1):32. doi: 10.1007/s00383-023-05619-3. PMID: 38196049; PMCID: PMC10776729.

13. Özek E, Kersin SG. Intraventricular hemorrhage in preterm babies. Turk Pediatri Ars. 2020 Sep 23; 55(3):215-221. doi: 10.14744/TurkPediatriArs.2020.66742. PMID: 33061747; PMCID: PMC7536465.

14. Wondie WT, Legesse BT, Mekonnen GB, Degaga GT, Zemariam AB, Gedefaw GD, et al. Incidence and predictors of respiratory distress syndrome among low birth weight neonates in the first seven days in Northwest Ethiopia Comprehensive Specialized Hospitals, 2023: A retrospective follow-up study. BMJ Open. 2023 Nov 19; 13(11):e079063. doi: 10.1136/bmjopen-2023-079063. PMID: 37984945; PMCID: PMC10660425.

15. Ito M, Kato S, Saito M, Miyahara N, Arai H, Namba F, et al. Bronchopulmonary Dysplasia in Extremely Premature Infants: A Scoping Review for Identifying Risk Factors. Biomedicines. 2023 Feb 14; 11(2):553. doi: 10.3390/biomedicines11020553. PMID: 36831089; PMCID: PMC9953397.

16. Casaburi G, Wei J, Kazi S, Liu J, Wang K, Tao GZ, et al. Metabolic model of necrotizing enterocolitis in the premature newborn gut resulting from enteric dysbiosis. Front Pediatr. 2022 Aug 23; 10:893059. doi: 10.3389/fped.2022.893059. PMID: 36081629; PMCID: PMC9445129.

17. Rozé JC, Cambonie G, Marchand-Martin L, Gournay V, Durrmeyer X, Durox M, et al; Hemodynamic EPIPAGE 2 Study Group. Association between Early Screening for Patent Ductus Arteriosus and In-Hospital Mortality among Extremely Preterm Infants. JAMA. 2015 Jun 23-30; 313(24):2441-8. doi: 10.1001/jama.2015.6734. PMID: 26103028.

18. Xu Y, Zhou X, Zhang Q, Ji X, Zhang Q, Zhu J, Chen C, Zhao P. Screening for retinopathy of prematurity in China: a neonatal units-based prospective study. Invest Ophthalmol Vis Sci. 2013 Dec 19; 54(13):8229-36. doi: 10.1167/iovs.13-12297. PMID: 24204053.

19. Preda A, Iliescu DG, Comănescu A, Zorilă GL, Vladu IM, Forțofoiu MC, et al. Gestational Diabetes and Preterm Birth: What Do We Know? Our Experience and Mini-Review of the Literature. J Clin Med. 2023 Jul 9; 12(14):4572. doi: 10.3390/jcm12144572. PMID: 37510687; PMCID: PMC10380752.

20. Li G, Xing Y, Wang G, Wu Q, Ni W, Jiao N, et al. Does recurrent gestational diabetes mellitus increase the risk of preterm birth? A population-based cohort study. Diabetes Research and Clinical Practice. 2023 May 1; 199:110628–8.

21. Boriboonhirunsarn D, Tanpong S. Rate of Spontaneous Preterm Delivery between Pregnant Women with and Without Gestational Diabetes. Cureus. 2023 Feb 2; 15(2):e34565. doi: 10.7759/cureus.34565. PMID: 36879686; PMCID: PMC9985512.

22. Damante CA, Foratori GA, Cunha P de O, Negrato CA, Sales-Peres SHC, Zangrando MSR, et al. Association among gestational diabetes mellitus, periodontitis and prematurity: a cross-sectional study. Archives of Endocrinology and Metabolism. 2022; 66(1):58–67.

23. Saha S, Saha S. A Comparison of Apgar Scores and Changes in the Neonates of Gestational Diabetes Mellitus Patients Treated with Metformin versus Glyburide: A Systematic Review. Dubai Diabetes and Endocrinology Journal. 2020;26(1):21–6.

24. Fuka F, Osuagwu UL, Agho K, Gyaneshwar R, Naidu S, Fong J, et al. Factors associated with macrosomia, hypoglycaemia and low Apgar score among Fijian women with gestational diabetes mellitus. BMC Pregnancy and Childbirth. 2020 Feb 28;20(1).

25. Muche AA, Olayemi OO, Gete YK. Gestational diabetes mellitus increased the risk of adverse neonatal outcomes: A prospective cohort study in Northwest Ethiopia. Midwifery. 2020 Aug; 87:102713.

26. Khan B, Allah Yar R, Khakwani AK, Karim S, Arslan Ali H. Preeclampsia Incidence and Its Maternal and Neonatal Outcomes With Associated Risk Factors. Cureus. 2022 Nov 6; 14(11):e31143. doi: 10.7759/cureus.31143. PMID: 36483900; PMCID: PMC9723483.

27. Bonanno C, Wapner RJ. Antenatal corticosteroids in the management of preterm birth: are we back where we started? Obstet Gynecol Clin North Am. 2012 Mar; 39(1):47-63. doi: 10.1016/j.ogc.2011.12.006. PMID: 22370107; PMCID: PMC4349395.

28. McDougall ARA, Aboud L, Lavin T, Cao J, Dore G, Ramson J, et al. Effect of antenatal corticosteroid administration-to-birth interval on maternal and newborn outcomes: a systematic review. EClinicalMedicine. 2023 Mar 24; 58: 101916. doi: 10.1016/j.eclinm.2023.101916. PMID: 37007738; PMCID: PMC10050784.

29. Ninan K, Liyanage SK, Murphy KE, Asztalos EV, McDonald SD. Evaluation of Long-term Outcomes Associated With Preterm Exposure to Antenatal Corticosteroids: A Systematic Review and Meta-analysis. JAMA Pediatr. 2022 Jun 1; 176(6):e220483. doi: 10.1001/jamapediatrics.2022.0483. Epub 2022 Jun 6. PMID: 35404395; PMCID: PMC9002717.

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Published

2025-05-31

How to Cite

Al-sheikh, M. S., & Hameed, N. N. (2025). Morbidities among Very Low Birth Weight and Very Preterm Infants of Diabetic Mothers: A Prospective, Cross-Sectional Study. International Journal of Pediatrics and Genetics , 3(5), 39–50. Retrieved from https://medicaljournals.eu/index.php/IJPG/article/view/1878

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