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Perinatal mortality and neonatal morbidity in infants of diabetic mothers

Condition	Rate, percent	Comments
Perinatal mortality	0.6 to 4.8	Lowest rates reflect very good prenatal care and strict glycemic control
Cesarean delivery	32 to 45	Highest rates are associated with lowest perinatal mortality
Prematurity
<37 weeks gestation	24 to 36
<34 weeks gestation	14 to 16
Congenital anomalies	1.7 to 9.4	Lowest rates are associated with strict glycemic control preconception and in early pregnancy
Perinatal asphyxia, including fetal distress during labor, low 1-minute Apgar score, and intrauterine death	9 to 27	Lowest rates are seen with close monitoring during labor and appropriate intervention
Macrosomia	9 to 47	Lowest rates are seen with strict glycemic control during pregnancy; strong association with neonatal hypoglycemia
Intrauterine growth restriction	2 to 8
Respiratory distress syndrome	2 to 6	Lower rates seen with strict glycemic control during pregnancy
Hypoglycemia	5 to 25	Strong correlation with macrosomia, lower rates seen with strict glycemic control during pregnancy
Hypocalcemia	4	Mostly asymptomatic
Polycythemia (hematocrit >65 percent)	5
Hyperbilirubinemia	11 to 29
Cardiomyopathy
Symptomatic	5 to 10
Asymptomatic	30 to 50

Note: The wide range cited for some complications is due to the inclusion of several studies, which were performed at different times, places in the world, and in different study groups (infants of all diabetic mothers, or those of gestational diabetic mothers or pregestational type 1 or 2 diabetic mothers). In many cases, different definitions of symptoms or findings were also used. In general, the lowest rates of complications are associated with improved obstetric care that resulted in better maternal glycemic control and neonatal management.

Graphic 80370 Version 5.0