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Definition:

An infant of a diabetic mother is a baby born to a mother who has diabetes. The phrase specifically refers to a baby who is born to a mother who had persistently high blood sugar (glucose) levels during pregnancy.



Alternative Names:

IDM



Causes, incidence, and risk factors:

High blood sugar levels in pregnant women often have specific effects on their infants. Infants born to mothers who have diabetes are generally larger than other babies. They may have large organs, particularly the liver, adrenal glands, and heart.

These infants may have a hypoglycemic episode (low blood sugar) shortly after birth because of the increased insulin in the baby. Insulin is a substance that moves glucose from the blood into body tissues. This requires close monitoring of blood sugar levels in the infant.

Overall, there is an increased chance that mothers with poorly controlled diabetes will have a miscarriage or stillborn child. If the mother was diagnosed with diabetes before the pregnancy, her infant also has an increased risk of having birth defects if her disease is not well controlled.



Symptoms:

The infant is usually large for gestational age. Other symptoms may include:

  • Blue or mottled skin color, rapid heart rate, rapid breathing (signs of heart failure)
  • Newborn jaundice
  • Poor feeding, lethargy, weak cry (signs of severe low blood sugar)
  • Puffy face
  • Reddish appearance
  • Tremors or shaking shortly after birth


Signs and tests:

An ultrasound performed on the mother in the last few months of pregnancy shows a large for gestational age baby.

After birth, tests may show that the infant has low blood sugar and low blood calcium. An echocardiogram may show an abnormally large heart, which can lead to heart failure.



Treatment:

All infants born to mothers with diabetes should be tested for low blood sugar (hypoglycemia), even if they have no symptoms.

If an infant had one episode of low blood sugar, tests to check blood sugars will be done over several days. This will continue until the infant's blood sugar remains stable with normal feedings.

Early feeding may prevent low blood sugar in mild cases. Persistent low blood sugar is treated with glucose given through a vein. Rarely, medications to treat other effects of diabetes on the infant are needed.



Support Groups:



Expectations (prognosis):

Better control of diabetes and early recognition of gestational diabetes has decreased the number and severity of problems in infants born to mothers with diabetes. Usually, an infant's symptoms go away within a few weeks. However, an enlarged heart may take several months to get better.



Complications:
  • Congenital heart defects
  • Heart failure
  • Neonatal polycythemia
  • Severe low blood sugar - may cause permanent brain damage
  • Small left colon syndrome - causes symptoms of intestinal blockage
  • Stillbirth


Calling your health care provider:

If you are pregnant and receiving routine prenatal care, routine testing will show if you develop gestational diabetes.

If you are pregnant and have diabetes that is difficult to controll, call your doctor immediately.

If you are pregnant and not receiving prenatal care, make an appointment with your heatlh care provider or call the State Board of Health for instructions on how to obtain state-assisted prenatal care.



Prevention:

Prevention of the complications associated with an infant of a diabetic mother requires supportive care of the mother throughout the pregnancy. Good control of blood sugars and and early recognition of gestational diabetes can prevent many of the problems associated with this condition.

Careful monitoring of the infant in the first 24 hours following birth may prevent complications due to low blood sugar.




Review Date: 10/15/2007
Reviewed By: Deirdre O’Reilly, MD, MPH, Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts. Review Provided by VeriMed Healthcare Network.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100