Dataset Information

Outcomes of Moderately Preterm Infants of Insulin-Dependent Diabetic Mothers.

ABSTRACT:

Objective

Little is known about the hospital outcomes of moderately preterm (MPT; 29 0/7-33 6/7 weeks gestational age) infants born to insulin-dependent diabetic mothers (IDDMs). We evaluated characteristics and outcomes of MPT infants born to IDDMs compared with those without IDDM (non-IDDM).

Study design

Cohort study of infants from 18 centers included in the MPT infant database from 2012 to 2013. We compared characteristics and outcomes of infants born to IDDMs and non-IDDMs.

Results

Of 7,036 infants, 527 (7.5%) were born to IDDMs. Infants of IDDMs were larger at birth, more often received continuous positive pressure ventilation in the delivery room, and had higher risk of patent ductus arteriosus (adjusted relative risk or aRR: 1.49, 95% confidence interval [CI]: 1.20-1.85) and continued hospitalization at 40 weeks postmenstrual age (aRR: 1.55, 95% CI: 1.18-2.05).

Conclusion

MPT infants of IDDM received more respiratory support and prolonged hospitalizations, providing further evidence of the important neonatal health consequences of maternal diabetes.

Key points

· Little data are available on moderate preterm infants of IDDMs.. · MPT infants of IDDMs need more respiratory support.. · Longer neonatal intensive care unit stays among MPT infants of IDDMs..

SUBMITTER: Gray KD

PROVIDER: S-EPMC10369370 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Publications

Outcomes of Moderately Preterm Infants of Insulin-Dependent Diabetic Mothers.

Gray Keyaria D KD Saha Shampa S Battarbee Ashley N AN Cotten Charles Michael CM Boghossian Nansi S NS Walsh Michele C MC Greenberg Rachel G RG

American journal of perinatology 20220317 9

<h4>Objective</h4>Little is known about the hospital outcomes of moderately preterm (MPT; 29 0/7-33 6/7 weeks gestational age) infants born to insulin-dependent diabetic mothers (IDDMs). We evaluated characteristics and outcomes of MPT infants born to IDDMs compared with those without IDDM (non-IDDM).<h4>Study design</h4>Cohort study of infants from 18 centers included in the MPT infant database from 2012 to 2013. We compared characteristics and outcomes of infants born to IDDMs and non-IDDMs.<h ...[more]

PMID: 35299277

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Project description:IntroductionInfants of diabetic mothers (IDMs) may exhibit decreased oral intake, requiring nasogastric feedings and prolonged hospitalization. The objective of this study was to explore whether saliva serves as an informative biofluid for detecting expression of hunger signaling and energy homeostasis modulator genes and to perform exploratory analyses examining expression profiles, body composition, and feeding outcomes in late preterm and term IDMs and infants born to mothers with normoglycemia during pregnancy.MethodsIn this prospective cohort pilot study, infants born at ≥ 35 weeks' gestation to mothers with gestational or type II diabetes (IDM cohort) and normoglycemic mothers (control cohort) were recruited. The presence of known hunger signaling genes: 5'AMP-activated protein kinase (PRKAA2) and neuropeptide Y2 receptor (NPY2R); adipokines: leptin (LEP) and adiponectin (ADIPOQ); and energy homeostasis regulators: ghrelin (GHRL) and proopiomelanocortin (POMC) in neonatal saliva was determined with RT-qPCR and compared between cohorts. Body composition was assessed via skinfold measurements and compared between cohorts. Feeding outcomes were recorded. Exploratory analyses were performed examining associations between infant body composition, energy homeostasis and hunger signaling gene expression.ResultsTwenty-three infants in the IDM cohort and 22 infants in the control cohort were recruited. LEP and ADIPOQ were not reliably detected in neonatal saliva in either cohort. PRKAA2, GHRL and NPY2R were less likely to be detected in the IDM cohort, whereas POMC was more likely to be detected in the IDM cohort. Infants in the IDM cohort had greater adiposity compared to infants in the normoglycemia cohort. Only 3 IDMs had documented poor feeding; no infant in the control group struggled to feed. In exploring associations between hunger signaling gene expression with energy homeostasis gene expression and body composition, the odds of detecting salivary NPY2R expression decreased as fat mass increased, and the odds of detecting PRKAA2 expression increased in the presence of GHRL expression.DiscussionNon-invasive assessment of hunger signaling and energy homeostasis gene expression is possible through neonatal salivary analysis. This pilot study lays the foundation for a larger scale study to further investigate the link between in utero exposure to diabetes with body composition and regulation of appetite.

Project description:To evaluate the impact of maternal hypertensive disorders of pregnancy (HDP) on mortality and neurological outcomes in extremely and very preterm infants using a nationwide neonatal database in Japan. This population-based retrospective study was based on an analysis of data collected by the Neonatal Research Network of Japan from 2003 to 2015 of neonates weighing 1,500 g or less at birth, between 22 and 31 weeks' gestation. A total of 21,659 infants were randomly divided into two groups, HDP (n = 4,584) and non-HDP (n = 4,584), at a ratio of 1:1 after stratification by four factors including maternal age, parity, weeks of gestation, and year of delivery. Short-term (neonatal period) and medium-term (3 years of age) mortality and neurological outcomes were compared between the two groups by logistic regression analyses. In univariate analysis, HDP was associated with an increased risk for in-hospital death (crude odds ratio [OR], 1.31; 95% confidence interval, 1.04-1.63) and a decreased risk for severe intraventricular haemorrhage (0.68; 0.53-0.87) and periventricular leukomalacia (0.60; 0.48-0.77). In multivariate analysis, HDP was significantly associated with a lower risk for in-hospital death (adjusted OR, 0.61; 0.47-0.80), severe intraventricular haemorrhage (0.47; 0.35-0.63), periventricular leukomalacia (0.59; 0.45-0.78), neonatal seizures (0.40; 0.28-0.57) and cerebral palsy (0.70; 0.52-0.95) at 3 years after adjustment for covariates including birth weight. These results were consistent with those of additional analyses, which excluded cases with histological chorioamnionitis and which divided the infants into two subgroups (22-27 gestational weeks and 28-31 gestational weeks). Maternal HDP was associated with an increased risk for in-hospital death without adjusting for covariates, but it was also associated with a lower risk for mortality and adverse neurological outcomes in extremely and very preterm infants if all covariates except HDP were identical.

Project description:INTRODUCTION:Many women cease breastfeeding earlier than desired. This study examined the cessation of breastfeeding among mothers of preterm infants. Thus, the aim was to describe the cessation of breastfeeding in mothers of preterm infants up to 12 months after birth. METHOD:This mixed methods study used a convergent design with both qualitative data, consisting of written comments, and quantitative data, on breastfeeding status and breastfeeding satisfaction. The data were collected from questionnaires sent to the mothers at three points during the first year after birth. In total, 270 mothers of preterm infants who breastfed at the time of discharge from the neonatal unit provided data for the study. The quantitative and qualitative data were analysed separately with statistical tests and hermeneutical analysis, respectively and then together according to the convergent mixed methods design. RESULTS:Four themes of the meanings of the cessation of breastfeeding were identified in the qualitative analysis: "Desire to regain the mother's and the infant's well-being", "The mothers interpretation that the infants actively ceased breastfeeding", "The mother's body and/or the infants' signals showing the way" and "The mother's own will and perceived external obstacles". Mothers who did not breastfeed as long as they wanted were more likely to report less satisfaction with breastfeeding, a shorter breastfeeding period, and less activity when ceasing breastfeeding. In comparison, mothers who breastfed as long as they wanted were more satisfied with breastfeeding, breastfed for a longer period of time and were more active in decision making in breastfeeding cessation. CONCLUSION:Maternal passivity or activity influenced the cessation of breastfeeding in mothers of preterm infants who breastfed at the time of discharge from the neonatal unit. Passive behaviour related to breastfeeding may result in early cessation of breastfeeding, and low breastfeeding satisfaction while active behaviour may increase breastfeeding length and satisfaction.

Dataset Information

Outcomes of Moderately Preterm Infants of Insulin-Dependent Diabetic Mothers.

Objective

Study design

Results

Conclusion

Key points

Publications

Outcomes of Moderately Preterm Infants of Insulin-Dependent Diabetic Mothers.

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