RELATIONSHIP BETWEEN LARGE FOR GESTATIONAL AGE AND APPROPRIATE FOR GESTATIONAL AGE INFANTS OF CLASS B DIABETIC MOTHERS

Abstract

To determine the relationship between intrauterine growth and neonatal morbidity in the infant of class B diabetic mother, we compared 145 appropriate for gestational age (AGA) infants and 41 large for gestational age (LGA) infants born from July 1985 to July 1986. California Intrauterine Growth Curves were used to categorize the infants. The mean birth weight of the AGA infants was 3260g compared with 4098g (p<0.001) of the LGA infants. Forty-five % of the AGA infants were born by C Section compared with 64% of the LGA infants (p<0.05). No differences were found in mean gestational age (AGA 37.8 weeks vs LGA 37.9 weeks), Apgar scores, initial calcium level, initial or peak bilirubin. Differences were found in glucose value done 30 minutes after birth (dextrostix), 39.7mg% in AGA vs 35.0mg% in LGA (p<0.001), in lowest glucose value (dextrostix), 33.3 mg% in AGA vs 31.4 mg% in LGA (p<0.005), and in highest hematocrit, 59.7% in AGA vs 61.2% in LGA (p<.01). There were no differences in need for intravenous glucose supplementation, in volume or in time of initiation of oral feeds. The great majority of infants did very well and did not require special observation after 12 hours. Only 12.5% of AGA and 9.8% of LGA infants remained hospitalized after five days. We conclude that the major management differences between the groups related to method of delivery and that minor differences did not affect the nursery course and management between the AGA and LGA infants.

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