CHU Ste-Justine Research Center, Montréal, QC, Canada.
Department of Neonatology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.
Am J Perinatol. 2024 May;41(S 01):e1581-e1590. doi: 10.1055/a-2053-7904. Epub 2023 Mar 14.
Infants of diabetic mothers (IDM) are at higher risk of perinatal morbidities and glycemic instability, but the impact of maternal diabetes on neonatal and neurological short-term outcomes of neonates with hypoxic-ischemic encephalopathy (HIE) remains poorly described. Our objective was to determine the impact of maternal diabetes on neonatal and neurological short-term outcomes following neonatal HIE.
This was a retrospective single-center study including 102 term neonates with HIE who received therapeutic hypothermia (TH) treatment between 2013 and 2020. Multiple regression analysis was used to assess the relationship between the presence of maternal diabetes and short-term outcomes.
Neonates with HIE and maternal diabetes exposure had a significantly lower gestational age at birth (38.6 vs. 39.7 weeks of gestation, = 0.005) and a significantly higher mean birth weight (3,588 ± 752 vs. 3,214 ± 514 g, = 0.012). IDM with HIE were ventilated for longer duration (8 vs. 4 days, = 0.0047) and had a longer neonatal intensive care unit (NICU) stay (18 vs. 11 days, = 0.0483) as well as took longer time to reach full oral feed (15 vs. 7 days, = 0.0432) compared with neonates of nondiabetic mother. Maternal diabetes was also associated with an increased risk of death or abnormal neurological examination at discharge in neonates with HIE (odds ratio: 6.41 [1.54-26.32]).
In neonates with HIE, maternal diabetes is associated with an increased risk of death or short-term neonatal morbidities, such as longer duration of ventilation, prolonged neonatal stay, greater need for tube feeding, and being discharged with an abnormal neurological examination. Strategies to prevent, reduce, or better control maternal diabetes during pregnancy should be prioritized to minimize complications after perinatal asphyxia.
· Maternal DB is associated with unfavorable outcomes.. · IDM have longer ventilatory support and tube feeding.. · IDM have higher risk of abnormal neurological examination..
糖尿病母亲所生婴儿（IDM）围产期发病率和血糖不稳定的风险更高，但糖尿病母亲对患有缺氧缺血性脑病（HIE）新生儿的新生儿和神经短期结局的影响仍描述不足。我们的目的是确定糖尿病母亲对新生儿 HIE 后新生儿和神经短期结局的影响。
这是一项回顾性单中心研究，纳入了 2013 年至 2020 年期间接受治疗性低温治疗的 102 例足月患有 HIE 的新生儿。采用多元回归分析评估母亲糖尿病的存在与短期结局之间的关系。
患有 HIE 并暴露于母亲糖尿病的新生儿的出生胎龄明显较低（38.6 周与 39.7 周，=0.005），且平均出生体重明显较高（3588±752g 与 3214±514g，=0.012）。患有 HIE 的 IDM 接受通气的时间更长（8 天与 4 天，=0.0047），新生儿重症监护病房（NICU）停留时间更长（18 天与 11 天，=0.0483），达到完全口服喂养的时间也更长（15 天与 7 天，=0.0432）。与非糖尿病母亲的新生儿相比。患有 HIE 的 IDM 也与死亡或出院时神经检查异常的风险增加相关（优势比：6.41[1.54-26.32]）。
患有 HIE 的新生儿中，母亲糖尿病与死亡或新生儿短期发病率增加相关，例如通气时间延长、新生儿住院时间延长、管饲需求增加，以及出院时出现神经检查异常。应优先制定预防、减少或更好控制妊娠期间母亲糖尿病的策略，以最大限度地减少围产期窒息后的并发症。
· 母亲糖尿病与不良结局相关。· IDM 需要更长时间的通气支持和管饲。· IDM 有更高的异常神经检查风险。
