PT  - JOURNAL ARTICLE
AU  - Daisuke Hitaka
AU  - Naho Morisaki
AU  - Yayoi Miyazono
AU  - Aurelie Piedvache
AU  - Motomichi Nagafuji
AU  - Syusuke Takeuchi
AU  - Daigo Kajikawa
AU  - Yu Kanai
AU  - Makoto Saito
AU  - Hidetoshi Takada
ED  - ,
TI  - Neonatal outcomes of very low birthweight infants born to mothers with hyperglycaemia in pregnancy: a retrospective cohort study in Japan
AID  - 10.1136/bmjpo-2019-000491
DP  - 2019 Jul 01
TA  - BMJ Paediatrics Open
PG  - e000491
VI  - 3
IP  - 1
4099  - http://bmjpaedsopen.bmj.com/content/3/1/e000491.short
4100  - http://bmjpaedsopen.bmj.com/content/3/1/e000491.full
SO  - BMJ Paediatrics Open2019 Jul 01; 3
AB  - Objective To examine the mortality and morbidities of very low birthweight (VLBW, <1500 g) infants of mothers with hyperglycaemia in pregnancy.Design and setting We conducted a retrospective cohort study using data from the Neonatal Research Network of Japan, a nationwide registry of VLBW infants (2003–2012).Patients We studied 29 626 infants born at 23 to 32 weeks without major congenital anomalies, of which 682 (2.3%) infants were from pregnancies affected by maternal hyperglycaemia.Main outcome measures The primary outcome was hospital mortality. Secondary outcomes were neonatal morbidities and their anthropometric values. Associations between maternal hyperglycaemia and each outcome were observed for the overall period, and statistical tests for interaction were conducted to assess whether they differed before or after the adoption of the International Association of Diabetes in Pregnancy Study Group (IADPSG) guidelines in 2010 for the diagnosis of gestational diabetes mellitus.Results Overall, hospital mortality (4.1% vs 5.2%), composite outcomes of mortality and severe morbidity (54.2% vs 60%), and anthropometric values were not significantly different between infants of mothers with or without hyperglycaemia in pregnancy. However, the incidence of respiratory distress syndrome (RDS) in VLBW infants from mothers with hyperglycaemia was significantly higher than those from mothers without it only before (relative risk (RR) 1.09, 95% CI 1.00 to 1.19) and not after (RR 0.97, 95% CI 0.83 to 1.11) the adoption of the IADPSG guidelines.Conclusion VLBW infants born to mothers with hyperglycaemia in pregnancy do not seem to be at higher risk of mortality and morbidities, except for RDS only before the adoption of the IADPSG guidelines.