Hyperinsulinism is the most common cause of hypoglycemia in early infancy. Congenital hyperinsulinism, formerly termed nesidioblastosis, is usually caused by genetic defects in beta-cell regulation, including a severe recessive disorder of the sulfonylurea receptor, a milder dominant form of hyperinsulinism, and a syndrome of hyperinsulinism plus hyperammonemia. Transient neonatal hyperinsulinism ...

The focus of monitoring in diabetic pregnancy is no longer the prevention of fetal mortality, owing to the impressive benefits of strict maternal glucose control. Against this background, fetal monitoring must account for congenital anomalies, fetal mortality and severe morbidity as a result of metabolic consequences of hyperinsulinism, the exponential ...

In this prospective study, we investigated the frequency of hypoglycemia and the proper intervals for screening in small-for-gestational-age (SGA) neonates. We determined test-strip blood glucose values at two, three, six, 12, 24 and 48 hours of age in 25 SGA and 16 appropriate-for-gestational-age (AGA) infants who were born after 37 ...

We report on a male infant with congenital hypoparathyroidism who developed primary hypothyroidism at 3 months and insulin-dependent diabetes mellitus at 25 months. He had evidence of widespread and progressive neurologic dysfunction characterized by severe developmental delay, blindness, deafness, seizures, atrophy of the cerebellar and frontal lobes, and elevated spinal ...

We report an infant with intrauterine growth retardation and transient neonatal diabetes who has paternal uniparental disomy for chromosome 6. The infant was not dysmorphic and had no congenital anomalies. To our knowledge, this is the third case of paternal uniparental disomy occurring in an infant with transient neonatal diabetes, ...

Thirty-five full term infants (38-41 weeks' gestation) were included in the study. Infants of mothers with complications of pregnancy, such as toxaemia, anaemia, diabetes, or hypertension were not included. All infants were fed during the first 3 hours of life and this was continued every 4 hours. Maternal glucose estimation ...

The effects of two structurally dissimilar aldose reductase inhibitors, Zopolrestat and Sorbinil, were investigated on the sodium-dependent, myo-inositol (MI) cotransporter in rat lenses maintained in either normal (5.5 mmol/l) or high sugar medium (35.5 mmol/l glucose or 30 mmol/l galactose). MI influx was compared to the lens polyol content. The ...

BACKGROUND: Microalbuminuria and nephropathy in diabetic subjects has been linked to low birth weight or short stature in adulthood. We have explored the relationship of foetal growth and intrauterine starvation with microalbuminuria in non-diabetic subjects. METHODS: Albumin excretion rate was measured in an overnight sample in 236 men and women ...

The study compares an occurrence rate of congenital malformations in newborn infants of mothers with insulin dependent diabetes (IDDM) and newborns of healthy mothers and mothers with pregnancy diabetes (GDM). This paper evaluates the influence of stage of advancement (a class) of diabetes in the mother and its control during ...

Aim of this study was to examine the maternal-neonatal outcome and the neonatal anthropometric characteristics of a full-term mother-infant pairs group with a positive oral glucose challenge test (GCT) without gestational diabetes mellitus (GDM). Our study involved 1615 white women with singleton pregnancies who underwent universal screening for GDM in ...

We compared the effects of two treatment strategies (diet alone versus a combination of insulin and diet) on neonatal anthropometric measurements and the outcome of a full-term white infant sample born to mothers with gestational diabetes mellitus (GDM). Study subjects included 217 consecutive nonrandomized women with GDM with term singleton ...

Extremely preterm infants have been shown capable of producing glucose at a rate comparable to that of term infants, but virtually no data are available on their capacity for lipolysis and gluconeogenesis. To address this issue, we studied the flux of glycerol and its gluconeogenic contribution to hepatic glucose output ...

AIMS: To compare two cotside methods of blood glucose measurement (HemoCue and Reflolux II) against a standard laboratory method for the detection of neonatal hypoglycaemia in a developing country maternity hospital where hypoglycaemia is common. METHODS: 94 newborn infants and 75 of their mothers had blood glucose assessed on the ...

OBJECTIVES: To compare risk factors and fetal morbidity in deliveries complicated by shoulder dystocia with deliveries of similar infant birthweights but not complicated by shoulder dystocia. DESIGN: A retrospective case-controlled study. SETTING: Kuwait Maternity Hospital. PARTICIPANTS: Sixty-nine cases of true shoulder dystocia and 138 controls matched for exact infant's birthweight. ...

To investigate the proliferative activity of cytomegalic cells in the fetal adrenal cortex, we studied adrenal glands with cytomegaly by immunohistochemistry using the nuclear proliferation maker MIB-1. The percentage of positively stained nuclei was quantified using the SAMBA 4000 image analysis system. Only one case showed occasional positively stained cytomegalic ...

Hypertrophic cardiomyopathy (HCM) is a rare primary myocardial disease, characterized by hypertrophy of the left and/or right ventricle. Infants of diabetic mothers (IDM) are at risk for development of HCM, respiratory distress and persistent pulmonary hypertension. A case of severe right sided HCM in an infant born to a diabetic ...

The purpose of this study was to evaluate the relationship between the severity of polyhydramnios with or without maternal diabetes and the prevalence of large-for-gestational-age newborn infants. A case control design was used. The study group consisted of 275 singleton pregnancies with an amniotic fluid index > or = 25.0 ...

OBJECTIVE: To investigate whether there was a temporal and geographical clustering of time of birth for infants with childhood-onset diabetes. RESEARCH DESIGN AND METHODS: The nationwide Swedish Childhood Diabetes Registry, which ascertains 99% of children with recent-onset diabetes (0-14 years), was linked with the Swedish Medical Birth Registry. Clustering of ...

Even though perinatal mortality of infants of diabetic mothers has decreased remarkably in recent years and now approaches that of the general population, these infants still face a multitude of potential complications and the propensity for increased morbidity, both in utero and postnatally. Many of these complications are clearly related ...

Diabetic mothers and their offspring were prospectively studied. Perinatal and neonatal morbidity and mortality data were analysed. Out of 11,677 deliveries in the hospital, 133 (1.14%) were delivered by diabetic mothers. They were made up of six (4.5%) stillbirths and 127 (95.5%) live births. Seventy-seven (57.9%), 55 (41.3%) and 1 ...

The history of the medical success in treatment of the pregnant diabetic woman and her infant in the twentieth century illustrates how the combined efforts of dedicated clinicians and researchers have resulted in dramatic improvements in outcome for this patient group. This article discusses fetal growth, metabolic complications of the ...

OBJECTIVE: To assess the relationship between the subtypes of hypertension in pregnancy and subsequent neonatal haematology. METHODOLOGY: Retrospective review of the haematology of newborns of hypertensive mothers at a tertiary neonatal unit. RESULTS: Over a 2 year period, 249 infants had full blood examinations. Nineteen (7.6%) were neutropenic and 35 ...

The aim of this study was to determine whether there is a gender-related difference in the morbidity and mortality of infants of diabetic mothers. We also wanted to identify risk factors associated with adverse pregnancy outcome, and create a perinatal morbidity index. We performed a retrospective review of 107 women ...

The authors evaluated the performance of the amniotic fluid surfactant to albumin ratio (FLM S/A), and disaturated phosphatidylcholine (DSPC) tests in assessing fetal lung maturity in infants of mothers with insulin-dependent diabetes mellitus antedating pregnancy. The distribution of the study population (n = 180) by class of diabetes was class ...

The aim of this prospective descriptive cross-sectional study was to examine the clinical significance of abnormal maternal serum human chorionic gonadotropin (MShCG) and alpha-fetoprotein (MSAFP) in the second trimester of pregnancy. The study group comprised 8892 women with a singleton pregnancy, who were screened for a neural tube defect and ...

OBJECTIVE: To assess the usefulness of the recently introduced TDx-FLM assay in managing pregnant women with diabetes. METHODS: Participating institutions were recruited from the 1993 and 1994 Society of Perinatal Obstetricians Diabetes Special Interest Group meetings. Study patients consisted of insulin-dependent diabetic women who had undergone transabdominal amniocentesis with assay ...

Several cardiologic pathologies are seen in infants of diabetic mothers (IDMs). Though asymmetrical septal hypertrophy (ASH) is a frequent pathology in IDMs, it is not routinely searched for with an echocardiographic scan. We have performed an echocardiographic examination for all IDMs (56 neonates) hospitalized between January 1987 and December 1992 ...

The neonatal polycythemia/hyperviscosity syndrome continues to perplex the pediatrician. Although it is reasonably common, with an incidence of 1% to 5%, significant symptoms are less frequent and may be more due to predisposing factors such as perinatal asphyxia, intrauterine hypoxia, or hypoglycemia. Infants who are small for gestational age or ...

OBJECTIVE: To evaluate the accuracy of diagnosing gestational diabetes mellitus (GDM) by a 2-h blood glucose value > or = 9.0 mmol/l in the 75 g oral glucose tolerance test (OGTT). The maternal and neonatal outcome in women with a 2-h blood glucose value just below this limit, 8.0-8.9 mmol/l, ...

Our objective was to compare the outcome of premature infants of mothers with preeclampsia and hypertension with properly matched controls to examine whether infants of mothers with preeclampsia are at a lesser risk. We designed a retrospective cohort study of 99 infants of mothers with preeclampsia and hypertension (IHM) at ...

The purpose of this study was to modify the traditional gestational diabetes screening process in order to provide a test that might more reliably detect those women at risk of delivering a macrosomic infant despite a negative test for gestational diabetes mellitus (GDM). Pregnant women (n = 160) were screened ...

OBJECTIVE: To determine the usefulness of an objective assessment of humeral soft tissue thickness in estimating birth weight in a population at risk for macrosomia. METHODS: Shortly before delivery, ultrasound examinations were performed on 95 women at risk of having macrosomic infants. In each case, the fetal humeral soft tissue ...

Subcutaneous microdialysis was used to monitor the immediate metabolic changes with respect to glucose, glycerol and lactate in the extracellular space of adipose tissue among five small-for-gestational-age (SGA) and two appropriate-for-gestational-age (AGA) newborns. There was a good correlation between glucose levels in blood and dialysate (r = 0.97, n = ...

Seventy-one pregnancies complicated by gestational diabetes and 100 healthy pregnancies were monitored on two occasions (between 27th-32nd and 33rd-36th week of gestation) by behavioural state analysis (1F coincidence; 2F coincidence) and umbilical artery Doppler velocimetry (UA) (Resistance Index, RI). The purpose of our study was to determine if the development ...

OBJECTIVE: To measure the incidence of microcephaly among infants of diabetic mothers (IDM) and assess its relationship to metabolic control during pregnancy. RESEARCH DESIGN AND METHODS: Head circumference data for 556 consecutive live-born singleton infants of women with insulin-requiring diabetes antedating pregnancy delivered between 28 and 40 weeks of gestation ...

In a previous study, asymptomatic infants of mothers with gestational diabetes (IGDMs) were observed to have altered left ventricular (LV) filling. In the present study, we reanalyzed the data to examine whether the observed abnormalities were related to maternal diabetes or due to the greater preponderance of macrosomic infants (32%) ...

We herein present two female siblings with persistent hyperinsulinemic hypoglycemia in the neonatal period who were diagnosed as having familial nesidioblastosis. Despite both the administration of diazoxide and the intravenous infusion of glucose, one of the affected infants died of severe metabolic acidosis at about 1 month of age, before ...

BACKGROUND: Recent evidence suggests that infant morbidity is increased among women who have abnormal prenatal glucose screening tests but who do not have gestational diabetes mellitus (GDM). These women fall into a diagnostic gray zone and historically have not been treated. METHODS: Forty-eight pregnant women with abnormal oral glucose challenge ...

Severe and mild deformations in newborn infants of insulin dependent diabetic mothers (IDDMs) and control mothers were evaluated with respect to the types of anomalies and previously hypothesized constraint factors. Factors evaluated were gestational length, birth weight, corrected birth weight for gestation (weight ratio), maternal height and parity, and severe ...

Renal venous thrombosis was diagnosed in the first week of life in 6 of 30,101 live infant births born at the Chaim Sheba Medical Center in Israel from 1984 to 1989. The thrombosis was unilateral in 5 neonates and bilateral in 1. Predisposing maternal risk factors included 2 cases of ...

Pregnancy in diabetic patients was uncommon before 1960 in Japan. It has increased recently and there has been a 3-fold increase since 1971. Only 26% of the cases of diabetic pregnancy had IDDM; the rest of cases had NIDDM. The perinatal mortality of infants decreased from 10.8% in 1971-1975 to ...

The aim of this study was to evaluate the influence of insulin-dependent diabetes mellitus in pregnant women on the kidney size of their infants. We measured kidney length in the first week of life using ultrasonography in 20 infants of tightly controlled insulin-dependent diabetic mothers and 20 healthy newborn controls, ...

The effect of rigorous management of insulin-dependent diabetes mellitus (IDDM) during pregnancy on the perinatal outcome was assessed by comparing 78 prepartum gravid patients with IDDM managed prospectively with 78 matched controls. The diabetic women were treated with insulin by either infusion pump or split-dose therapy, with the goal of ...

Infants of diabetic mothers have three to four times the incidence of congenital malformations than that in the general population. These anomalies include defects of the neural tube, heart, urogenital system, skeleton and alimentary tract, and the caudal regression syndrome. The anomalies are considered to result from the maternal metabolic ...

Between 1983 and 1986, 914 single births to women with diabetes mellitus before pregnancy and a randomly selected control sample of 4000 births were identified by using the Swedish Medical Birth Registry. Twenty-four percent of diabetic women were delivered preterm, as compared with 6% in the control group. The rates ...

Haptoglobin (Hp) development during the neonatal period has been studied in 325 newborn infants from normal pregnancies and in 242 infants from diabetic mothers. In infants from diabetic mothers Hp development is delayed as compared to infants from normal pregnancies. This delay is associated with a change in the pattern ...

OBJECTIVE: Our purpose was to compare the endocrine pancreas of hydropic infants of immune and nonimmune origin. STUDY DESIGN: A quantitative morphologic study was performed on the pancreas in 10 infants with immune and nonimmune hydrops. The volume density of the endocrine pancreas in the gland was calculated, as was ...

The neurodevelopmental consequences of maternal insulin-dependent diabetes were studied in 109 infants of diabetic mothers and 90 control infants. The infants born to diabetic mothers included 70 "early entry" subjects and 39 "late entry" subjects. Maternal diabetes control during pregnancy was significantly better in "early entry" mothers than in late-entry ...

OBJECTIVE: To evaluate retrospectively the glucose metabolism of women who gave birth to large babies. RESEARCH DESIGN AND METHODS: Within the first 3 days of postpartum, HbA1c of the dense erythrocytes and glycated albumin were measured. The sample group was comprised of 59 women who gave birth to heavy-for-dates infants. ...

OBJECTIVE: To test the hypothesis that strict control of diabetes during pregnancy can reduce the risk for neonatal hypocalcemia in infants of diabetic mothers. METHODS: One hundred thirty-seven pregnant women with insulin-dependent diabetes enrolled before 9 weeks' gestation were randomized to one of two treatment groups. In 68 subjects, the ...