Impact of maternal diabetes mellitus on mortality and morbidity of very low birth weight infants: a multicenter Latin America study
Objectives: To compare mortality and morbidity in very low birth weight infants (VLBWI) born to women with and without diabetes mellitus (DM). Methods: This was a cohort study with retrospective data collection (2001–2010, n = 11.991) from the NEOCOSUR network. Adjusted odds ratios and 95% confidenc...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2015-05-01
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| Series: | Jornal de Pediatria |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0021755714001612 |
| _version_ | 1798004718992097280 |
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| author | Carlos Grandi Jose L. Tapia Viviane C. Cardoso |
| author_facet | Carlos Grandi Jose L. Tapia Viviane C. Cardoso |
| author_sort | Carlos Grandi |
| collection | DOAJ |
| description | Objectives: To compare mortality and morbidity in very low birth weight infants (VLBWI) born to women with and without diabetes mellitus (DM). Methods: This was a cohort study with retrospective data collection (2001–2010, n = 11.991) from the NEOCOSUR network. Adjusted odds ratios and 95% confidence intervals were calculated for the outcome of neonatal mortality and morbidity as a function of maternal DM. Women with no DM served as the reference group. Results: The rate of maternal DM was 2.8% (95% CI: 2.5-3.1), but a significant (p = 0.019) increase was observed between 2001-2005 (2.4%, 2.1-2.8) and 2006-2010 (3.2%, 2.8-3.6). Mothers with DM were more likely to have received a complete course of prenatal steroids than those without DM. Infants of diabetic mothers had a slightly higher gestational age and birth weight than infants of born to non-DM mothers. Distribution of mean birth weight Z-scores, small for gestational age status, and Apgar scores were similar. There were no significant differences between the two groups regarding respiratory distress syndrome, bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalacia, and patent ductus arteriosus. Delivery room mortality, total mortality, need for mechanical ventilation, and early-onset sepsis rates were significantly lower in the diabetic group, whereas necrotizing enterocolitis (NEC) was significantly higher in infants born to DM mothers. In the logistic regression analysis, NEC grades 2-3 was the only condition independently associated with DM (adjusted OR: 1.65 [95% CI: 1.2 -2.27]). Conclusions: VLBWI born to DM mothers do not appear to be at an excess risk of mortality or early morbidity, except for NEC. Resumo: Objetivos: Comparar mortalidade e morbidade em crianças de muito baixo peso (MBP) filhas de mães com e sem diabetes mellitus (DM). Métodos: Estudo de coorte com coleta retrospectiva de dados (2001 - 2010, n = 11.991) da rede NEOCOSUR. Odds ratios ajustados foram calculados para mortalidade e morbilidade neonatal em função da DM materna. Mulheres sem DM serviram como grupo de referência. Resultados: A taxa de DM materna foi 2,8% (IC 95% 2,5-3,1), mas um aumento significativo (p = 0,019) entre 2001-2005 (2,4%) e 2006-2010 (3,2%) foi observado. As mães com DM eram mais propensas a terem recebido um curso completo de esteróides pré-natais que as sem DM. Os bebês de mães diabéticas tinham uma idade gestacional e peso ao nascer um pouco maior do que crianças filhas de não DM. Distribuição dos z escores de peso ao nascer, pequeno para idade gestacional e escores de Apgar foram semelhantes. Não houve diferenças significativas entre os dois grupos em termos de síndrome do desconforto respiratório, displasia broncopulmonar, hemorragia intraventricular, leucomalácia periventricular e persistência do ductus arteriosus. Mortalidade na sala de parto, mortalidade total, necessidade de ventilação mecânica e as taxas de sepse neonatal precoce foram significativamente menores no grupo diabético, enquanto enterocolite necrosante (NEC) foi significativamente maior em recém-nascidos de mães diabéticas. Em análises de regressão logística NEC foi a única condição independentemente associada com DM (OR ajustado 1,65 [IC 95% 1,21 -2,27]). Conclusões: Crianças de MBP de mães com DM não têm aumento do risco de mortalidade ou morbidade precoce, exceto NEC. Keywords: Very low birth weight, Diabetes mellitus, Morbidity, Mortality, Neonatal, Network, Palavras-chave: Muito baixo peso, Diabetes mellitus, Morbilidade, Mortalidade, Neonatal, Redes |
| first_indexed | 2024-04-11T12:27:51Z |
| format | Article |
| id | doaj.art-4ef0a07bec99430f9bf130289e33bf35 |
| institution | Directory Open Access Journal |
| issn | 0021-7557 |
| language | English |
| last_indexed | 2024-04-11T12:27:51Z |
| publishDate | 2015-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Jornal de Pediatria |
| spelling | doaj.art-4ef0a07bec99430f9bf130289e33bf352022-12-22T04:23:52ZengElsevierJornal de Pediatria0021-75572015-05-01913234241Impact of maternal diabetes mellitus on mortality and morbidity of very low birth weight infants: a multicenter Latin America studyCarlos Grandi0Jose L. Tapia1Viviane C. Cardoso2Department of Pediatrics, Faculty of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina; Corresponding author.Department of Pediatrics, Faculty of Medicine, Pontificia Universidad Catolica de Chile, Santiago, ChileRibeirão Preto Medical School, Universidade de São Paulo, São Paulo, BrazilObjectives: To compare mortality and morbidity in very low birth weight infants (VLBWI) born to women with and without diabetes mellitus (DM). Methods: This was a cohort study with retrospective data collection (2001–2010, n = 11.991) from the NEOCOSUR network. Adjusted odds ratios and 95% confidence intervals were calculated for the outcome of neonatal mortality and morbidity as a function of maternal DM. Women with no DM served as the reference group. Results: The rate of maternal DM was 2.8% (95% CI: 2.5-3.1), but a significant (p = 0.019) increase was observed between 2001-2005 (2.4%, 2.1-2.8) and 2006-2010 (3.2%, 2.8-3.6). Mothers with DM were more likely to have received a complete course of prenatal steroids than those without DM. Infants of diabetic mothers had a slightly higher gestational age and birth weight than infants of born to non-DM mothers. Distribution of mean birth weight Z-scores, small for gestational age status, and Apgar scores were similar. There were no significant differences between the two groups regarding respiratory distress syndrome, bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalacia, and patent ductus arteriosus. Delivery room mortality, total mortality, need for mechanical ventilation, and early-onset sepsis rates were significantly lower in the diabetic group, whereas necrotizing enterocolitis (NEC) was significantly higher in infants born to DM mothers. In the logistic regression analysis, NEC grades 2-3 was the only condition independently associated with DM (adjusted OR: 1.65 [95% CI: 1.2 -2.27]). Conclusions: VLBWI born to DM mothers do not appear to be at an excess risk of mortality or early morbidity, except for NEC. Resumo: Objetivos: Comparar mortalidade e morbidade em crianças de muito baixo peso (MBP) filhas de mães com e sem diabetes mellitus (DM). Métodos: Estudo de coorte com coleta retrospectiva de dados (2001 - 2010, n = 11.991) da rede NEOCOSUR. Odds ratios ajustados foram calculados para mortalidade e morbilidade neonatal em função da DM materna. Mulheres sem DM serviram como grupo de referência. Resultados: A taxa de DM materna foi 2,8% (IC 95% 2,5-3,1), mas um aumento significativo (p = 0,019) entre 2001-2005 (2,4%) e 2006-2010 (3,2%) foi observado. As mães com DM eram mais propensas a terem recebido um curso completo de esteróides pré-natais que as sem DM. Os bebês de mães diabéticas tinham uma idade gestacional e peso ao nascer um pouco maior do que crianças filhas de não DM. Distribuição dos z escores de peso ao nascer, pequeno para idade gestacional e escores de Apgar foram semelhantes. Não houve diferenças significativas entre os dois grupos em termos de síndrome do desconforto respiratório, displasia broncopulmonar, hemorragia intraventricular, leucomalácia periventricular e persistência do ductus arteriosus. Mortalidade na sala de parto, mortalidade total, necessidade de ventilação mecânica e as taxas de sepse neonatal precoce foram significativamente menores no grupo diabético, enquanto enterocolite necrosante (NEC) foi significativamente maior em recém-nascidos de mães diabéticas. Em análises de regressão logística NEC foi a única condição independentemente associada com DM (OR ajustado 1,65 [IC 95% 1,21 -2,27]). Conclusões: Crianças de MBP de mães com DM não têm aumento do risco de mortalidade ou morbidade precoce, exceto NEC. Keywords: Very low birth weight, Diabetes mellitus, Morbidity, Mortality, Neonatal, Network, Palavras-chave: Muito baixo peso, Diabetes mellitus, Morbilidade, Mortalidade, Neonatal, Redeshttp://www.sciencedirect.com/science/article/pii/S0021755714001612 |
| spellingShingle | Carlos Grandi Jose L. Tapia Viviane C. Cardoso Impact of maternal diabetes mellitus on mortality and morbidity of very low birth weight infants: a multicenter Latin America study Jornal de Pediatria |
| title | Impact of maternal diabetes mellitus on mortality and morbidity of very low birth weight infants: a multicenter Latin America study |
| title_full | Impact of maternal diabetes mellitus on mortality and morbidity of very low birth weight infants: a multicenter Latin America study |
| title_fullStr | Impact of maternal diabetes mellitus on mortality and morbidity of very low birth weight infants: a multicenter Latin America study |
| title_full_unstemmed | Impact of maternal diabetes mellitus on mortality and morbidity of very low birth weight infants: a multicenter Latin America study |
| title_short | Impact of maternal diabetes mellitus on mortality and morbidity of very low birth weight infants: a multicenter Latin America study |
| title_sort | impact of maternal diabetes mellitus on mortality and morbidity of very low birth weight infants a multicenter latin america study |
| url | http://www.sciencedirect.com/science/article/pii/S0021755714001612 |
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