Infant of diabetic mother

Alternative names

IDM

Definition

An infant of a diabetic mother is, by definition, an infant born to a mother who suffers from diabetes mellitus, but this term refers specifically to the infant born to a mother who had persistently elevated blood sugar (glucose) during pregnancy.

Causes, incidence, and risk factors

Elevated blood sugar in pregnant women often has specific effects on their infants. Infants of diabetic mothers are generally larger and may have large organs and systems, particularly the liver, adrenal glands, and heart.

These infants may have a hypoglycemic episode (low blood sugar) shortly after birth because of the increased fetal production of insulin (a substance that moves glucose from the bloodstream into body tissues) in response to maternal high blood sugar. This requires close monitoring of blood sugar levels in these infants.

Overall, there is an increased chance that mothers with poorly-controlled diabetes will miscarry or have a stillborn child. If the mother was diagnosed with diabetes before the pregnancy, her infant also has an increased risk of having congenital malformations if her disease is not well controlled.

Symptoms

• Mother had previous large for gestational age (LGA) infant
  
• Infant is large for gestational age (LGA)
  
• Infant has
  o Reddish appearance (plethoric)
  o Puffy face
  o Tremors or shaking shortly after birth
  o Jaundice of the skin
  o Poor feeding, lethargy, weak cry (signs of severe low blood sugar)
  o Blue or mottled skin color, rapid heart rate, rapid breathing (signs of heart failure)
  

Signs and tests

In the mother, signs include:

• History of diabetes or gestational diabetes
  
• Poor glucose control during pregnancy
  
• Ultrasound demonstrates LGA in late term
  

In the infant, signs include:

• Macrosomia (abnormally large body)
  
• Hypoglycemia - low blood sugar
  
• Hypocalcemia - low blood calcium
  
• Abnormally large heart causing heart failure
  

In the infant, tests include: