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Neonatal complications of children of diabetic mothers
Mothers with type 1 or 2 diabetes mellitus can have children without problems, but prenatal control is stricter, since the probability of complications is always latent.
However, complications can begin to occur, even while the fetus is in the womb.
On the other hand, when the baby is born, complications can be short-term and long-term.
Know the neonatal complications of the children of diabetic mothers.
Child of a diabetic mother
The fact that a mother is diabetic does not mean that her child will have complications at birth, but the risk of this newborn is high.
However, studies show that complications are more frequent in mothers with pre-gestational diabetes. These are women who are diabetic or discover the disease for the first time during pregnancy.
In relation to the above, the children of mothers with gestational diabetes have a lower probability of developing complications.
What is true is that mothers who have poor metabolic control during pregnancy, possibly, their children suffer complications in the neonatal stage.
What are the most frequent complications of a child of a diabetic mother?
Complications are usually metabolic, related to birth weight, fetal growth retardation, malformations, immaturity, and hematologic abnormalities.
Of all the above, metabolic complications and changes in birth weight are the most frequent.
The most prevalent metabolic problems are hypoglycemia and hypocalcemia.
50% of the children of diabetic mothers may have decreased blood sugar levels (hypoglycemia).
The reason for this is that intrauterine exposure to high maternal sugar levels causes an increase in the number of cells in the fetal pancreas.
In this sense, your pancreas begins to release too much insulin, thanks to all the glucose it received during pregnancy, due to poor metabolic control.
On the other hand, hypocalcemia can occur in 20% to 40% of newborns of diabetic mothers, but the cause is unknown.
A fetus is said to be macrosomic when its birth weight exceeds 4 kilos.
In these fetuses, excess sugar from the mother causes fetal growth, but it is not muscle tissue, but adipose tissue.
For this reason, they are large fetuses, with a weight and a size that is not according to their gestational age, their face is usually very round. In addition, abundant adipose tissue can be seen on the nape.
This alteration can be detected through ultrasound during pregnancy.
In turn, other complications are associated during childbirth, such as clavicle fracture, perinatal asphyxia, among others.
Fetal growth restriction
The fetus does not grow or develop because of a nutritional deficiency, but because of a deficient supply of oxygen.
Generally, between 10% and 20% of diabetic mothers suffer from decreased placental blood flow.
This can occur in the first weeks of gestation, with the most common genetic malformations being the following.
Neurological malformations such as spina bifida or anencephaly.
Cardiac malformations such as intraventricular communication.
What should be the treatment of diabetic mothers?
Of course, prenatal control is essential, in this way, alterations can be detected in a timely manner.
Additionally, prenatal management should be carried out by a multidisciplinary team and not just by an obstetrician. The intervention of a perinatologist, internist, nutritionist, among others is required.
In addition to this, the non-pharmacological measures, whether it is a patient with pre-gestational diabetes or gestational diabetes.
It is recommended that the mother eats in a healthy way, without excluding food groups. Likewise, exercise is necessary, as long as there are no contraindications.
For mothers who require treatment to manage glycemic figures, the treatment of choice is insulin. The use of hypoglycemic medications such as metformin is not advised.
Finally, it is good to mention that the cases of diabetic mothers must be individualized, since all diabetic patients in a state of pregnancy are different.