Diabetes in Pregnancy, Neonatal Morbidities, and Early Growth in Moderate or Late Preterm Infants

• Published in: Pediatrics (Evanston) 2023-12, Vol.152 (6), p.1
• Main Authors: Buck, Catherine O, Shabanova, Veronika, Clark, Reese H, Taylor, Sarah N
• Format: Article
• Language: English
• Subjects: Birth Weight; Congenital defects; Diabetes; Diabetes Mellitus; Female; Gestational Age; Humans; Hyperbilirubinemia; Hypoglycemia; Infant; Infant, Newborn; Infant, Premature; Infants; Intensive care; Intensive care units; Intensive Care Units, Neonatal; Morbidity; Neonates; Newborn babies; Pediatrics; Pregnancy; Pregnancy Complications; Premature babies
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2023-061285

To compare differences in short term morbidities and early growth among moderate and late preterm infants of mothers with and without diabetes (DM) in pregnancy. In a longitudinal analysis using data from the Pediatrix Clinical Data Warehouse of preterm infants (born 32 0/7 to 36 6/7 weeks) discharged from neonatal intensive care units from 2008 to 2019, health characteristics were compared between DM exposure groups. Change in growth from birth to discharge were compared using linear mixed effects modeling. Among 301 499 moderate and late preterm infants in the analysis, 14% (N = 42 519) were exposed to DM in pregnancy. Incidence of congenital anomalies, hypoglycemia, and hyperbilirubinemia were higher in DM-group (P < .001), and DM-group was more likely to need respiratory support in the first postnatal days (P = .02). Percent weight change from birth differed by gestational age, such that 36-week DM-group infants remained on average 2% (95% confidence interval [CI]: 1.57 to 2.41) below birth weight on day 14, whereas 32-week DM-group infants were on average 2.1% (95% CI: 1.69 to 2.51) above birth weight on day 14. In the regression analysis, DM-group had faster weight loss in the first postnatal week when stratified by gestational age. The adjusted difference in weight velocity (g per day) from days 0 to 3 was -4.5 (95% CI: -5.1 to -3.9), -6.5 (95% CI: -7.4 to -5.7), and -7.2 (95% CI: -8.2 to -6.2) for infants born 34-, 35-, and 36-weeks, respectively. In moderate or late preterm infants, diabetes in pregnancy is associated with common neonatal morbidities. Examination of intensive care nutritional practices may identify reasons for observed differences in weight trajectories by gestational age and diabetes exposure.