Persson M, et al. - This retrospective cohort study was designed to evaluate the relationships between maternal diabetes and in-hospital mortality and in addition neonatal morbidity in very preterm infants with a birth weight of less than 1500 g. Researchers reported that maternal diabetes was not correlated with an increased risk of in-hospital mortality or severe morbidity in very preterm infants with a birth weight of fewer than 1500 g in high-resource settings.

Methods

• This investigation was performed at 7 national networks in high-income countries that are part of the International Neonatal Network for Evaluating Outcomes in Neonates.
• Researchers used prospectively collected data on 76,360 very preterm, singleton infants without malformations born between January 1, 2007, and December 31, 2015, at 24 to 31 weeks’ gestation with birth weights of less than 1500 g, 3280 (4.3%) of whom were born to diabetic mothers.
• Any type of diabetes during pregnancy was the main exposures.
• In-hospital mortality was the primary outcome.
• Severe neonatal morbidities, including intraventricular hemorrhages of grade 3 to 4, cystic periventricular leukomalacia, retinopathy of prematurity needing treatment and bronchopulmonary dysplasia, and other morbidities, including respiratory distress, treated patent ductus arteriosus, and necrotizing enterocolitis were the included secondary outcomes.
• They evaluated odds ratios (ORs) with 95% confidence intervals, adjusted for potential confounders, and stratified by gestational age (GA), sex, and network.

Results

• The study results showed that the mean (SD) birth weight of offspring born to mothers with diabetes was significantly higher at 1081 (262) g than in offspring born to mothers without diabetes (mean [SD] birth weight, 1027 [270] g).
• It was observed that out of 76,360 infants, 25,962 (34%) and 33,598 (44%) were born before 28 weeks of gestation to mothers with and without diabetes, respectively.
• As compared to mothers without diabetes, mothers with diabetes were older and had more hypertensive disorders, antenatal steroid treatments, and deliveries by cesarean delivery.
• It was noted that infants of mothers with diabetes were born at a later GA than infants of mothers without diabetes.
• In infants of mothers with diabetes, in-hospital mortality (6.6% vs 8.3%) and the composite of mortality and severe morbidity (31.6% vs 40.6%) were lower.
• No significant differences in in-hospital mortality (adjusted OR, 1.16 (95% CI, 0.97-1.39) or the composite of mortality and severe morbidity (adjusted OR, 0.99 (95% CI, 0.88-1.10) were found in adjusted analyses.
• Outcomes of infants born to mothers with and without diabetes were similar regardless of infant sex, GA, or country of birth with few exceptions.