Outcomes of Extremely Preterm Infants Born to Insulin-Dependent Diabetic Mothers

Nansi S Boghossian; Nellie I Hansen; Edward F Bell; Jane E Brumbaugh; Barbara J Stoll; Abbot R Laptook; Seetha Shankaran; Myra H Wyckoff; Tarah T Colaizy; Abhik Das; Rosemary D Higgins; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

doi:10.1542/peds.2015-3424

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Outcomes of Extremely Preterm Infants Born to Insulin-Dependent Diabetic Mothers

Journal article

Open access

Peer reviewed

Outcomes of Extremely Preterm Infants Born to Insulin-Dependent Diabetic Mothers

Nansi S Boghossian, Nellie I Hansen, Edward F Bell, Jane E Brumbaugh, Barbara J Stoll, Abbot R Laptook, Seetha Shankaran, Myra H Wyckoff, Tarah T Colaizy, Abhik Das, …

Pediatrics (Evanston), Vol.137(6), pp.e20153424-e20153424

06/2016

DOI: 10.1542/peds.2015-3424

PMCID: PMC4894251

PMID: 27244849

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Abstract

Little is known about in-hospital morbidities and neurodevelopmental outcomes among extremely preterm infants born to women with insulin-dependent diabetes mellitus (IDDM). We examined risks of mortality, in-hospital morbidities, and neurodevelopmental outcomes at 18 to 22 months' corrected age between extremely preterm infants of women with insulin use before pregnancy (IBP), with insulin use started during pregnancy (IDP), and without IDDM. Infants 22 to 28 weeks' gestation born or cared for at a Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network center (2006-2011) were studied. Regression models compared the association between maternal IDDM and timing of insulin use and the outcomes of the 3 groups. Of 10 781 infants, 536 (5%) were born to women with IDDM; 58% had IBP, and 36% had IDP. Infants of mothers with IBP had higher risks of necrotizing enterocolitis (adjusted relative risk [RR] = 1.55 [95% confidence interval (CI) 1.17-2.05]) and late-onset sepsis (adjusted RR = 1.26 [95% CI 1.07-1.48]) than infants of mothers without IDDM. There was some indication of higher in-hospital mortality risk among infants of mothers with IBP compared with those with IDP (adjusted RR = 1.33 [95% CI 1.00-1.79]). Among survivors evaluated at 18 to 22 months' corrected age, average head circumference z score was lower for infants of mothers with IBP compared with those without IDDM, but there were no differences in risk of neurodevelopmental impairment. In this cohort of extremely preterm infants, infants of mothers with IBP had higher risks of necrotizing enterocolitis, sepsis, and small head circumference.

Neurodevelopmental Disorders - epidemiology

Infant, Extremely Premature - growth & development

Follow-Up Studies

Humans

Pregnancy in Diabetics - drug therapy

Sepsis - epidemiology

Organ Size

Head - anatomy & histology

Infant

Male

Diabetes Mellitus, Type 1 - drug therapy

Enterocolitis, Necrotizing - epidemiology

Pregnancy

Regression Analysis

Adult

Female

Infant, Newborn

Insulin - therapeutic use

Cohort Studies

Details

Title: Subtitle: Outcomes of Extremely Preterm Infants Born to Insulin-Dependent Diabetic Mothers
Creators: Nansi S Boghossian - Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
Nellie I Hansen - Social, Statistical, and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina
Edward F Bell - Department of Pediatrics, University of Iowa, Iowa City, Iowa; edward-bell@uiowa.edu
Jane E Brumbaugh - Department of Pediatrics, University of Iowa, Iowa City, Iowa
Barbara J Stoll - Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia
Abbot R Laptook - Department of Pediatrics, Brown University and Women & Infants Hospital of Rhode Island, Providence, Rhode Island
Seetha Shankaran - Department of Pediatrics, Wayne State University, Detroit, Michigan
Myra H Wyckoff - Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Parkland Health & Hospital System and Children's Medical Center Dallas, Dallas, Texas
Tarah T Colaizy - Department of Pediatrics, University of Iowa, Iowa City, Iowa
Abhik Das - Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville, Maryland; and
Rosemary D Higgins - Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
Resource Type: Journal article
Publication Details: Pediatrics (Evanston), Vol.137(6), pp.e20153424-e20153424
DOI: 10.1542/peds.2015-3424
PMID: 27244849
PMCID: PMC4894251
NLM abbreviation: Pediatrics
ISSN: 0031-4005
eISSN: 1098-4275
Publisher: American Academy of Pediatrics
Grant note: U10 HD053124 / NICHD NIH HHS UG1 HD027904 / NICHD NIH HHS U10 HD053119 / NICHD NIH HHS U10 HD027871 / NICHD NIH HHS M01 RR008084 / NCRR NIH HHS UL1 RR025764 / NCRR NIH HHS M01 RR016587 / NCRR NIH HHS U10 HD040498 / NICHD NIH HHS UG1 HD053109 / NICHD NIH HHS U10 HD021373 / NICHD NIH HHS U10 HD040492 / NICHD NIH HHS U10 HD021397 / NICHD NIH HHS U10 HD068244 / NICHD NIH HHS U10 HD036790 / NICHD NIH HHS U10 HD040521 / NICHD NIH HHS U10 HD068270 / NICHD NIH HHS U10 HD053089 / NICHD NIH HHS U10 HD040689 / NICHD NIH HHS U10 HD027904 / NICHD NIH HHS U10 HD053109 / NICHD NIH HHS U10 HD027856 / NICHD NIH HHS U10 HD027880 / NICHD NIH HHS U10 HD027853 / NICHD NIH HHS U10 HD021364 / NICHD NIH HHS U10 HD068284 / NICHD NIH HHS U10 HD068278 / NICHD NIH HHS U10 HD027851 / NICHD NIH HHS UG1 HD087229 / NICHD NIH HHS U10 HD034216 / NICHD NIH HHS UG1 HD040689 / NICHD NIH HHS M01 RR007122 / NCRR NIH HHS U10 HD021385 / NICHD NIH HHS U10 HD068263 / NICHD NIH HHS U10 HD040461 / NICHD NIH HHS UG1 HD027856 / NICHD NIH HHS
Language: English
Date published: 06/2016
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9984093504802771

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