Infants of Diabetic Mothers

Question 1

Describe complications in newborns of diabetic mothers.

Answer 1

Sudden fetal death in the 3rd trimester, macrosomia, birth trauma, perinatal asphyxia, increased rate of c-sections, IUGR, temperature instability, hypoglycemia, hypocalcemia, hypomagnesiumia, unconjugated hyperbili, polycythemia, cardiomegaly/HCOM, CHD (septal defects, asymmetric septal hypertrophy, TGA, TA, CoA), RDS, small left colon syndrome, renal anomalies, renal vein thrombosis, congenital anomalies (lumbosacral dysgenesis/caudal regression), increased risk of obesity and diabetes later in life.

Question 2

What are the effects of maternal hyperglycemia on the fetus?

Answer 2

Leads to fetal hyperglycemia, resulting in fetal pancreatic B-cell stimulation and hyperinsulinemia.

Question 3

Does gestation diabetes itself cause congenital anomalies?

Answer 3

Still at increased risk for all mentioned morbidities, except congenital anomalies and future obesity/diabetes.

Question 4

What congenital anomalies do you see in infants of diabetic women?

Answer 4

VSDs, neural tube defects, GI atresia, situs inversus, and urinary tract anomalies.

Spinal agenesis with caudal regression syndrome and microcolon.