Postnatal growth and weight gain in term and near-term infants with severe neonatal hypoglycemia: A comparison between offspring of diabetic and non-diabetic mothers
Growth of infants who have severe neonatal hypoglycemia
Keywords:
Neonatal hypoglycemia, postnatal growth, infants of diabetic mothers, infants of non diabetic mothersAbstract
Objective: This study aimed to evaluate postnatal growth patterns in infants with neonatal hypoglycemia, comparing infants of diabetic mothers (IDM) with infants of non-diabetic mothers (INDM) from birth to 3 years of age. Methods: We retrospectively analyzed the growth data of 79 IDM and 51 INDM infants who were treated for severe neonatal hypoglycemia at a single center. Anthropometric measurements, including weight-for-age Z score (WAZ), length-for-age Z score (LAZ), and weight-for-length Z score (WLZ), were collected at birth and at several intervals up to 36 months. Results: IDM were born at a higher gestational age and with better growth indices than INDM. During the first year, IDM had a progressive increase in WAZ, which stabilized thereafter, while INDM presented a significant catch-up in WAZ and LAZ, particularly in the first 18 months. After 2 months, IDM maintained higher WLZ scores than INDM. By 36 months, IDM had significantly higher WAZ and WLZ, suggesting a tendency towards increased weight relative to length. Conclusion: The growth patterns of infants with neonatal hypoglycemia are influenced by maternal diabetes status. While IDMs are at risk for increased adiposity, both groups show resilience in growth, underscoring the need for ongoing monitoring to support their growth needs
References
Guemes M, Rahman SA, Hussain K. What is a normal blood glucose? Arch Dis Child. 2016; 101:569–74.doi: 10.1136/archdischild-2015-308336.
Lord K, De León DD. Hyperinsulinism in the Neonate. Clin Perinatol. 2018, 45:61–74. doi: 10.1016/j.clp.2017.10.007.
Languren G, Montiel T, Julio-Amilpas A, Massieu L. Neuronal damage and cognitive impairment associated with hypoglycemia: An integrated view. Neurochem Int. 2013;63(4):331-43. doi: 10.1016/j.neuint.2013.06.018.
Fong CY, Harvey AS. Variable outcome for epilepsy after neonatal hypoglycaemia. Dev Med Child Neurol. 2014; 56:1093–9. doi: 10.1111/dmcn.12496.
Tam EW, Haeusslein LA, Bonifacio SL, et al. Hypoglycemia is associated with increased risk for brain injury and adverse neurodevelopmental outcome in neonates at risk for encephalopathy. J Pediatr. 2012:161:88–93.doi: 10.1016/j.jpeds.2011.12.047.
Yang G, Zou LP, Wang J, Shi X, et al. Neonatal hypoglycemic brain injury is a cause of infantile spasms. Exp Ther Med. 2016; 11:2066–70.doi: 10.3892/etm.2016.3107.
Touger L, Looker HC, Krakoff J, et al. Early growth in offspring of diabetic mothers. Diabetes Care. 2005;28(3):585-9. doi: 10.2337/diacare.28.3.585.
Vohr BR, Lipsitt LP, Oh W. Somatic growth of children of diabetic mothers with reference to birth size. J Pediatr. 1980;97(2):196-9. doi: 10.1016/s0022-3476(80)80473-2.
Hu J, Liu Y, Wei X, et al. Association of gestational diabetes mellitus with offspring weight status across infancy: a prospective birth cohort study in China. BMC Pregnancy Childbirth. 2021:21:21. doi.org/10.1186/s12884-020-03494-7.
Guo B, Pei J, Xu Y, et al. Effects of early standardized management on the growth trajectory of offspring with gestational diabetes mellitus at 0–5 years old: a preliminary longitudinal study. Sci Rep. 2023;13:13939. doi:10.1038/s41598-023-40928-6.
Geurtsen ML, van Soest EEL, Voerman E, et al. High maternal early-pregnancy blood glucose levels are associated with altered fetal growth and increased risk of adverse birth outcomes. Diabetologia. 2019 ;62(10):1880-90. doi: 10.1007/s00125-019-4957-3.
Ornoy A, Becker M, Weinstein-Fudim L, Ergaz Z. Diabetes during pregnancy: A maternal disease complicating the course of pregnancy with long-term deleterious effects on the offspring. A clinical review. Int J Mol Sci. 2021;15;22(6):2965. doi: 10.3390/ijms22062965.
Thorn SR, Rozance PJ, Brown LD, Hay WW Jr. The intrauterine growth restriction phenotype: fetal adaptations and potential implications for later life insulin resistance and diabetes. Semin Reprod Med. 2011;29(3):225-36. doi: 10.1055/s-0031-1275516.
Sharma A, Davis A, Shekhawat PS. Hypoglycemia in the preterm neonate: etiopathogenesis, diagnosis, management and long-term outcomes. Transl Pediatr. 2017;6(4):335-48. doi: 10. 21037/tp.2017.10.06.
Abramowski A, Ward R, Hamdan AH. Neonatal hypoglycemia. [Updated 2023 Sep 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK537105/.
Zhao T, Liu Q, Zhou M, et al. Identifying risk effectors involved in neonatal hypoglycemia occurrence. Biosci Rep. 2020;40(3):BSR20192589. doi:10.1042/BSR20192589.
Kallem VR, Pandita A, Gupta G. Hypoglycemia: When to treat?. Clin Med Insights Pediatr. 2017;11:1179556517748913. doi:10.1177/1179556517748913.
Bayoumi MAA, Masri RM, Matani NYS, et al. Maternal and neonatal outcomes in mothers with diabetes mellitus in Qatari population. BMC Pregnancy Childbirth. 2021;21:651. doi:10.1186/ s12884-021-04124-6.
Touger L, Looker HC, Krakoff J, Lindsay RS, Cook V, Knowler WC. Early growth in offspring of diabetic mothers. Diabetes Care. 2005;28(3):585-9. doi: 10.2337/diacare.28.3.585.
Plagemann A, Harder T, Kohlhoff R, Rohde W, Dörner G. Overweight and obesity in infants of mothers with long-term insulin-dependent diabetes or gestational diabetes. Int J Obes Relat Metab Disord. 1997;21(6):451-6. doi: 10.1038/sj.ijo.0800429.
Martin SL, Zhang L, Callahan ML, et al. Mother-child cardiometabolic health 4-10 years after pregnancy complicated by obesity with and without gestational diabetes. Obes Sci Pract. 2022; 8(5):627-40. doi: 10.1002/osp4.599.
Ornoy A, Ratzon N, Greenbaum C, Wolf A, Dulitzky M. School-age children born to diabetic mothers and to mothers with gestational diabetes exhibit a high rate of inattention and fine and gross motor impairment. J Pediatr Endocrinol Metab. 2001;14 (Suppl 1):681-9. doi: 10.1515/ jpem.2001.14.s1.681.
Ornoy A, Ratzon N, Greenbaum C, Peretz E, et al. Neurobehaviour of school age children born to diabetic mothers. Arch Dis Child Fetal Neonatal Ed. 1998 ;79(2):F94-9. doi: 10.1136/ fn.79. 2.f94.
Ornoy A, Wolf A, Ratzon N, Greenbaum C,et al. Neurodevelopmental outcome at early school age of children born to mothers with gestational diabetes. Arch Dis Child Fetal Neonatal Ed. 1999;81(1):F10-F4. doi:10.1136/fn.81.1.f10.
Stupin JH, Arabin B. Overweight and obesity before, during and after pregnancy: Part 1: Pathophysiology, molecular biology and epigenetic consequences. Geburtshilfe Frauenheilkd. 2014;74(7):639-45. doi:10.1055/s-0034-1368486.
Soliman A, Salama H, Al Rifai H, et al. The effect of different forms of dysglycemia during pregnancy on maternal and fetal outcomes in treated women and comparison with large cohort studies. Acta Biomed. 2018;89(S5):11-21. doi:10.23750/abm.v89iS4.7356.
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Copyright (c) 2024 Ashraf T Soliman, Nada Alaaraj, Vincenzo De Sanctis, Fawzia Alyafei , Noor Hamed, shayma Ahmed, Hamdy Ali, Fatima Alnaimi, Maya Itani, Bassant Okab
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