Diabetes in pregnancy associated with common neonatal morbidities

Key takeaways:

• Diabetes in pregnancy is associated with common neonatal morbidities in babies born moderately or late preterm.
• In all, 14% of study participants were exposed to gestational diabetes in pregnancy.

Diabetes in pregnancy is associated with a higher likelihood of common neonatal comorbidities in babies born moderately or late-preterm, such as a need for respiratory support, according to a study published in Pediatrics.

“My research program is very interested in the perinatal environment,” Catherine O. Buck, MD, a neonatologist and clinical researcher at Yale School of Medicine and co-author of the study, told Healio. “We wanted to look at diabetes in pregnancy and how that may be associated with early growth changes in preterm sense.”

Buck and colleagues used data from the Clinical Data Warehouse, which collects data from newborn intensive care units across the country in pediatric health systems.

“They have this rich database that can be used for research questions, so we utilized data from that data set looking at moderate to late-born infants at 32 to 36 weeks’ gestational age,” Buck said. “We were able to pull data from maternal health looking at diabetes exposure, and then information about growth outcomes during the hospitalization.”

In a cohort of 301,499 moderate and late-preterm infants, 14% were exposed to diabetes in pregnancy. The incidence of congenital anomalies, hypoglycemia and hyperbilirubinemia was higher in the population with gestational diabetes, and that group was also more likely to need respiratory support in the first postnatal days, including noninvasive support (49.6% vs. 47.7%; P = .02).

Percent weight change from birth also differed by gestational age, such that infants in the gestational diabetes group who were born at 36 weeks remained on average 2% (95% CI, 1.57-2.41) below birth weight on day 14, whereas 32-week infants in the gestational diabetes group were on average 2.1% (95% CI, 1.69-2.51) above birth weight on day 14.

“We found some differences in growth related to whether the mom had diabetes or not,” Buck said. “I think in these infants, specifically, there are few studies that help guide our management in the newborn ICU. Looking at different factors that may affect early growth in this population, hopefully, will help to guide our nutritional management clinically so that we’re giving these babies the optimal nutrition to improve their later outcomes.

“I think that we certainly need more information to really apply this clinically,” Buck continued. “We really just wanted to the research community, or the community that takes care of these babies, to notice that some of these early exposures may lead to changes in growth and just help us to think about [whether] we need to treat these babies in a different way to improve their outcome.”