Yenidoğan Yoğun Bakımında Yedi Yıllık Diyabetik Anne Bebeği Deneyimi

Year 2012, , 169 - 176, 01.10.2012

Belma Saygılı Karagöl Nilgün Karadağ Ayşegül Zenciroğlu Ahmet Afşin Kundak Nurullah Okumuş

https://doi.org/10.5222/j.child.2012.169

Abstract

Amaç: Diyabet, gebelik süresince fetal gelişimi olumsuz etkileyen, yenidoğanlarda metabolik bozukluklara yol açan önemli bir hastalıktır. Çalışmamızda, diyabetik anne bebeklerinde gelişen metabolik ve sistemik komplikasyonların gebelik takipleri ile birlikte değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Ocak 2005-Aralık 2011 yılları arasında kliniğimizde diyabetik anne bebeği DAB tanısı ile izlenmiş yenidoğan bebeklerde klinik bulgular ve laboratuvar verileri, annelere ait demografik özellikler incelendi.Bulgular: Çalışma süresi içerisinde 86 yenidoğan DAB tanısı aldı. Bu bebeklerin annelerinde gestasyonel % 84,9 veya insüline bağımlı diabetes mellitus GDM İDDM % 15.1 saptandı. Annelerin ortalama yaşı 31,2 yıl, glikolize hemoglobin HbA1c median değerleri ise 5,9 % 5,0-7,9% idi. Gebelik süresi içerisinde annelerin % 11,6’sında hipertansiyon, % 5,8’inde preeklampsi ve % 3,5’inde polihidroamniyoz gözlenirken, % 60,8’inde ek bir komplikasyon saptanmadı. Annelerin ortalama gebelik süresi süresi 37,9±1,9 haftayken, doğumların % 82,6 n=71 ‘sı zamanında, % 17,4 n=15 ’ü ise preterm olarak gerçekleşti. Sezaryen doğum oranı % 31,4, bebeklerin ortalama doğum ağırlığı 3500 gr bulundu. Çalışmada bebeklerin 44 % 51,2 ’ü, erkek, 42 % 48,8 ’si kız cinsiyetinde iken, makrozomi sıklığı % 34,9 idi. Bebeklerde RDS % 4,6 n=4 , konjestif kalp yetmezliği % 10,4 n=9 , hipoksik iskemik ensefalopati % 10,4 n=9 , brakiyal pleksus paralizisi % 3,5 n=3 , hipoglisemi % 32,5 n=28 , polisitemi % 27,9 n=24 , indirekt hiperbilirubinemi % 25,5 n=22 ve hipokalsemi % 11,6 n=10 oranında bulundu. Tromboz 14 % 16,2 vakada saptandı. Annenin HbA1c düzeyi ile RDS, hipoglisemi, hipokalsemi ve polisitemi gelişimi arasında bir ilişki saptanmazken p>0,05 , HbA1c düzeyi arttıkça majör anomali sıklığında artış görüldü p

Keywords

Diyabetik anne bebeği, komplikasyonlar, morbidite, mortalite

A Seven Year Experience On Infants of Diabetic Mothers In A Neonatal Intensive Care Unit

Abstract

Objective: Diabetes is an important disease causing an adverse effect of fetal development during pregnancy and metabolic defects in newborn babies. In this study, it was aimed to determine the metabolic and systemic complications of infants of diabetic mothers with pregnancy follow-ups.Material and Method: Clinical findings and laboratory data with mothers’ sociodemographic properties were evaluated in neonates with the diagnosis of infants of diabetic mothers IDM that were followed in our clinic between January 2005-December 2011. Results: During the study period, 86 neonates were diagnosed with IDM. The incidence of gestational diabetes mellitus GDM of the mothers of these infants was 84.9% and the incidence of insulin dependent diabetes mellitus IDDM was 15.1 %. Mothers’ mean age was 31.2 years and the mean value of glycated hemoglobin HbA1c was 5.9 5.0-7.9 . Hypertension 11.6 % , preeclampsia 5.8 % and polyhydroamniosis 3.5 % incidences were detected in mothers while there was no additional complication in 60.8 % of the mothers. Mean pregnancy duration of the mothers was 37.9±1.9 weeks, while the incidence of term , and preterm births were 82.6 % n=71 and 17.4 % n=15 , respectively. The frequency of the cesarian section was 31.4 % and the mean birth weights of the babies were found as 3500 g 1200-5259 g . Babies were of male 51.2 %: n=44 , female 48.8 %: n=42 gender, while macrosomia 34.9 % . RDS 4.6 %: n=4 , congestive heart failure 10.4 % :n=9 , hypoxic ischemic encephalopathy 10.4 % : n=9 , brachial plexus paralysis 3.5 %: n=3 , hypoglycemia 32.5 % n=28 , polycythemia 27.9 %: n=24 , indirect hyperbilirubinemia 25.5 %: n=22 , and hypocalcemia 11.6 %: n=10 were detected in babies. Thrombosis was found to be in 14 16.2 % infants. There was no correlation between the level of HbA1c of mothers and RDS, hypogycemia, hypocalcemia and polycythemia p>0.05 , while the incidence of major malformation was seemed to rise with the increase of HbA1c level p

Keywords

Infant of diabetic mother, complications, morbidity, mortality

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