Clinical Profile and Outcome of Infant of Diabetic Mother in Tertiary Care (NICU) in Rural Maharastra.
Abstract
Background: Infants of diabetic mothers (IDMs) face unique challenges that require specialized care. The management of these high-risk neonates in rural tertiary care settings presents additional complexities due to resource limitations. This study aimed to evaluate the clinical profile and outcomes of IDMs in a rural tertiary care Neonatal Intensive Care Unit (NICU) in Maharashtra.
Methods: This observational analytical study included 50 infants born to mothers with preexisting or gestational diabetes mellitus admitted to our rural tertiary care NICU. We analyzed maternal characteristics, neonatal complications, and short-term outcomes. The study evaluated various parameters including gestational age, birth weight, metabolic complications, respiratory morbidities, and immediate outcome.
Results: Among the study population, 54% were male infants, with 30% being preterm. Birth weight distribution showed 16% small for gestational age, 62% appropriate for gestational age, and 22% large for gestational age infants. Major complications included hypoglycemia (36%), respiratory problems (38% combined, including 14% requiring surfactant), and hyperbilirubinemia (30%). Congenital anomalies were observed in 12% of cases. The survival rate was 94%, with a median NICU stay of 7 days. Poor maternal glycemic control significantly correlated with adverse neonatal outcomes (adjusted OR 2.8, 95% CI 1.4-5.6, p=0.003).
Conclusion: Despite resource limitations, rural tertiary care centers can achieve favorable outcomes in managing IDMs through systematic protocols and vigilant monitoring. The study highlights the importance of maternal glycemic control and early intervention in preventing complications. The findings provide valuable insights for developing standardized protocols tailored to rural healthcare settings, though larger multicenter studies are needed to validate these results.
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References
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