Document Detail


Perinatal asphyxia in infants of insulin-dependent diabetic mothers.
MedLine Citation:
PMID:  3397799     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Infants of diabetic mothers are thought to be at risk for perinatal asphyxia. We hypothesized that the following are significant risk factors for perinatal asphyxia: poor third-trimester glycemic control, diabetic vascular disease (nephropathy, retinopathy) appearing in pregnancy, pregnancy-associated hypertension, smoking, prematurity, fetal macrosomia, and maternal hyperglycemia and hypoglycemia within 6 hours preceding delivery. We prospectively studied 162 infants born to 149 diabetic mothers (White classes B through R-T). Perinatal asphyxia was defined clinically as fetal distress during labor (late decelerations, persistent fetal bradycardia, or both), 1-minute Apgar score less than or equal to 6, or intrauterine fetal death. Forty-four infants (26.7%) had perinatal asphyxia. The presence of perinatal asphyxia did not correlate with third-trimester glycemic control, pregnancy-associated hypertension, smoking, fetal macrosomia, or maternal hypoglycemia before delivery, but it did correlate significantly with nephropathy appearing in pregnancy, maternal hyperglycemia before delivery, and prematurity. We speculate that (1) the appearance of diabetic vasculopathy (nephropathy) during pregnancy is accompanied by placental vascular disease and subsequently by fetal compromise and (2) in pregnancy complicated by diabetes, maternal and subsequently fetal hyperglycemia before delivery leads to fetal hypoxemia.
Authors:
F Mimouni; M Miodovnik; T A Siddiqi; J Khoury; R C Tsang
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  113     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  1988 Aug 
Date Detail:
Created Date:  1988-09-08     Completed Date:  1988-09-08     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  345-53     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, OH 45267-0541.
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MeSH Terms
Descriptor/Qualifier:
Adult
Asphyxia Neonatorum / etiology*
Blood Glucose / analysis
Diabetes Mellitus, Type 1 / blood,  complications*
Diabetic Nephropathies / complications
Female
Fetal Death / etiology*
Fetal Distress / etiology*
Humans
Hyperglycemia / complications
Infant, Newborn
Infant, Premature
Pregnancy
Pregnancy in Diabetics / complications*
Prospective Studies
Grant Support
ID/Acronym/Agency:
HD-11725/HD/NICHD NIH HHS; HD-20748/HD/NICHD NIH HHS; RR-00068/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Blood Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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