PREVALENCE OF HYPOCALCEMIA IN INFANT OF DIABETIC MOTHER

A  ALI; S QURATULAIN; MU FAROOQ; A LIAQAT

doi:10.54112/bcsrj.v2024i1.1189

Authors

A ALI Taluka Hospital Samaro Umerkot, Pakistan
S QURATULAIN Green Belt Dispensary Mehmoodabada, Pakistan
MU FAROOQ District Headquarter Hospital Mianwali, Pakistan
A LIAQAT Peads Unit 2 Allied Hospital Faisalabad, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1189

Keywords:

Diabetes, Gestational, Hypocalcemia, Infant, Newborn, Maternal Health, Vitamin D Deficiency

Abstract

Calcium plays an important role in the body, such as in the contraction of muscles, the transmission of nerve impulses and the calcification of bones, blood clotting, blood vessel constriction, cell division, cell membrane stability, lipid metabolism, and other essential metabolic processes. Objective: The main objective of the study is to find the prevalence of hypocalcemia in infants of diabetic mothers. Methods: This prospective observational study was conducted at National Institute of Child and Health Karachi during January 2024 to June 2024.Data were collected from 255 infants whose mothers were suffering from DM.Data were collected through a designed questionnaire which include all information related to demographics, age, history of DM and other comorbidities. Maternal data included the type of diabetes (gestational or pregestational), maternal glycemic control measured by HbA1c levels, maternal vitamin D status, and the presence of any other comorbidities, such as hypertension or obesity. Results: Data were collected from 255 infants with 31.4% born preterm and 68.6% born full-term. The majority of the infants (76.5%) had a normal birth weight (≥ 2.5 kg), while 23.5% had a low birth weight (< 2.5 kg). In terms of gender distribution, the cohort was nearly balanced, with 51.0% male and 49.0% female infants. Regarding the mode of delivery, 54.9% were delivered via cesarean section, and 45.1% were born through vaginal delivery. Infants born to mothers with poor glycemic control (HbA1c > 7%) had a higher prevalence of hypocalcemia (38.3%) compared to those with better control (19.3%). Maternal vitamin D deficiency also contributed to the risk, with 42.4% of infants affected. Neonatal hypoglycemia was strongly associated with hypocalcemia, with a prevalence of 40.0% in hypoglycemic infants. Conclusion: This study concludes that hypocalcemia is prevalent among infants of diabetic mothers (IDMs), with poor maternal glycemic control and vitamin D deficiency being significant risk factors. Early detection through routine screening, particularly in those with neonatal hypoglycemia, is essential as many cases are asymptomatic. Timely calcium supplementation effectively resolves the condition, emphasizing the importance of optimizing maternal care and standardized neonatal monitoring to improve outcomes in this high-risk population.

Downloads

Download data is not yet available.

References

Vuralli D. Clinical approach to hypocalcemia in newborn period and infancy: who should be treated? International journal of pediatrics. 2019;2019(1):4318075.

Rafiq W, Hussain SQ, Jan M, Najar BA. Clinical and metabolic profile of neonates of diabetic mothers. Int J Contemp Pediatr. 2015;2(2):114-8.

Fazel-Sarjoui Z, Namin AK, Kamali M, Namin NK, Tajik A. Complications in neonates of mothers with gestational diabetes mellitus receiving insulin therapy versus dietary regimen. International Journal of Reproductive BioMedicine. 2016;14(4):275.

Opara PI, Jaja T, Onubogu UC. Morbidity and mortality amongst infants of diabetic mothers admitted into a special care baby unit in Port Harcourt, Nigeria. Italian journal of pediatrics. 2010;36:1-6.

Mitanchez D, Yzydorczyk C, Simeoni U. What neonatal complications should the pediatrician be aware of in case of maternal gestational diabetes? World journal of diabetes. 2015;6(5):734.

Abdul TC, Saldanha PR, Sahana K. High maternal HbA1c is associated with neonatal hypocalcemia. Journal of Evolution of Medical and Dental Sciences. 2014;3(55):12531-7.

Merchant R, Dalvi R, Vidwans A. Infant of the diabetic mother. 1990.

Mahmood CB, Kayes MI. Problems and immediate outcome of infants of diabetic mothers. Journal of Bangladesh College of Physicians & Surgeons. 2008;26(2):67.

Awan NN, Abbas S, Naz M, Jameel M, Iftikhar S. Frequency of Hypocalcemia in Infants of Diabetic Mothers within 24 Hours of Life. Pakistan Journal of Medical & Health Sciences. 2023;17(02):586-.

Khalesi N, Namiranian P, Samavati S, Farahani Z. The frequency of early and late hypocalcemia among hospitalized newborns in an iranian hospital. Shiraz E-Medical Journal. 2015;16(6).

Rosenn B, Miodovnik M, Tsang R. Common clinical manifestations of maternal diabetes in newborn infants: implications for the practicing pediatrician. Pediatric annals. 1996;25(4):215-22.

Tsang RC, Kleinman LI, Sutherland JM, Light IJ. Hypocalcemia in infants of diabetic mothers: studies in calcium, phosphorus, and magnesium metabolism and parathormone responsiveness. The Journal of pediatrics. 1972;80(3):384-95.

Sugawara D, Maruyama A, Imanishi T, Sugiyama Y, Ichihashi K. Complications in infants of diabetic mothers related to glycated albumin and hemoglobin levels during pregnancy. Pediatrics & Neonatology. 2016;57(6):496-500.

Geiss LS, Wang J, Cheng YJ, Thompson TJ, Barker L, Li Y, et al. Prevalence and incidence trends for diagnosed diabetes among adults aged 20 to 79 years, United States, 1980-2012. Jama. 2014;312(12):1218-26.

Afshari F, Abbasalizade F, Faraji M. Comparative evaluation of two treatment regimens, diet versus insulin, in gestational diabetes mellitus. European Journal of Experimental Biology. 2013;3(4):71-6.

Toor KM, Wahid S, Azeem K. Frequency of Metabolic Complications in Infants Born to Diabetic Mothers at KRL Hospital, Islamabad. Journal of Islamabad Medical & Dental College. 2015;4(1):23-6.

Kumar S, Bhatla N, Sharma KA, Agarwal R, Verma A, Perumal V, et al. SCOPE: Surveillance of COVID-19 in pregnancy-results of a multicentric ambispective case-control study on clinical presentation and maternal outcomes in India between April to November 2020. PLoS One. 2023;18(3):e0272381.

Khan M, Malik KA, Bux K. PROFILE OF COMPLICATIONS IN INFANTS BORN TO DIABETIC MOTHERS. Medical Channel. 2016;22(2).

Ashraf S, Mushtaq S. Metabolic Complications and Outcome of Infants Born to Diabetic Mothers. Journal of Rawalpindi Medical College. 2018;22(1).

Iqbal W, Shamaoon M, Masood M, Butt MA. The frequency of metabolic complications in infant of a diabetic mother. Annals of Punjab Medical College. 2018;12(1):16-9.