Gestational, pregestational diabetes linked to poor neonatal outcomes

Neonatal outcomes may be adversely affected with the presence of gestational diabetes or pregestational diabetes, independent of other conditions that may complicate pregnancy, according to findings presented at the 52nd European Association for the Study of Diabetes Annual Meeting.

“Both [gestational diabetes] and [pregestational diabetes] are associated with adverse neonatal outcomes compared to normal pregnancy,” Basilio Pintaudi, MD, of the interdisciplinary diabetes and pregnancy unit at Ca’Granda Niguarda Hospital in Milan, told Endocrine Today. “However, their independent role in conferring higher risks of adverse pregnancy outcomes compared with normal pregnancy has not been completely or systematically studied. The main reason for this is that several significant medical conditions of impairing pregnancy outcomes were not simultaneously taken into account in most of the medical conditions capable of impairing pregnancy outcomes were not simultaneously taken into account in most of the performed studies on the topic.”

Basilio Pintaudi

Pintaudi and colleagues evaluated administrative data from the Italian Puglia region from 2002 to 2012 on 1,357 pregnancies complicated by gestational diabetes and 234 pregnancies complicated by diabetes to determine t he risks for adverse neonatal outcomes.

Gestational diabetes was associated with higher risks for neonatal hypoglycemia (OR = 10.1; 95% CI, 8.5-11.9), small for gestational age (OR = 1.7; 95% CI, 1.4-2), large for gestational age (OR = 1.7; 95% CI, 1.3-2.1), jaundice (OR = 1.7; 95% CI, 1.5-2), fetal malformations (OR = 2.2; 95% CI, 1.7-2.8), hypocalcemia and hypomagnesemia of newborn (OR = 1.8; 95% CI, 1.2-3) and cesarean section delivery (OR = 1.9; 95% CI, 1.7-2.2).

Diabetes before gestation was also associated with higher risks for neonatal hypoglycemia (OR = 36; 95% CI, 27.1-47.8), small for gestational age (OR = 5.8; 95% CI, 4.4-7.7), large for gestational age (OR = 7.9; 95% CI, 5.7-10.9), jaundice (OR = 2.6; 95% CI, 1.8-3.6), fetal malformations (OR = 3.5; 95% CI, 2.2-5.7), hypocalcemia and hypomagnesemia of newborn (OR = 9.2; 95% CI, 5.5-15.5) and cesarean section delivery (OR = 8.5; 95% CI, 5.6-12.9). Diabetes before gestation was also associated with an increased risk for respiratory distress (OR = 2.7; 95% CI, 1.7-4.3) and alteration of the amniotic fluid (OR = 46.5; 95% CI, 19.52-110.57), whereas gestational diabetes was not.

“We noticed a very high risk for neonatal hypoglycemia in the case of pregestational diabetes and this was greater than we expected,” Pintaudi told Endocrine Today. “The findings of a high risk for electrolyte disorders is clinically important being this outcome is not typically explored. The finding that pregestational diabetes but not gestational diabetes was associated with high risk of respiratory distress and alteration of the amniotic fluid could drive clinicians involved in the care of pregnancy in preventing or delaying — if possible — these specific conditions.” – by Amber Cox

Reference:

Pintaudi B, et al. Poster 924. Presented at: 52nd EASD Annual Meeting; Sept. 12-16, 2016; Munich.

Disclosure: The researchers report no relevant financial disclosures.