A cross-sectional study on neonatal morbidities and birth defects in diabetic pregnancies in Malaysia : a single hospital study

Background: National data regarding the neonatal outcome of infants of diabetic mothers is lacking despite Malaysia having one of the highest incidences of diabetic pregnancies in the region. This study aimed to describe the various neonatal morbidities and birth defects in infants of diabetic mothe...

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Main Author:	Ramdzan, Muhammad Yusoff Mohd
Format:	Thesis
Language:	English
Published:	2018
Subjects:	RG Gynecology and obstetrics
Online Access:	http://eprints.usm.my/45735/1/Dr%20Muhammad%20Yusoff-24%20pages.pdf
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spelling	my-usm-ep.457352019-10-29T01:55:07Z A cross-sectional study on neonatal morbidities and birth defects in diabetic pregnancies in Malaysia : a single hospital study 2018 Ramdzan, Muhammad Yusoff Mohd RG Gynecology and obstetrics Background: National data regarding the neonatal outcome of infants of diabetic mothers is lacking despite Malaysia having one of the highest incidences of diabetic pregnancies in the region. This study aimed to describe the various neonatal morbidities and birth defects in infants of diabetic mothers and analyse their risk factors. Methods: In this cross-sectional, descriptive study spanning four months, antenatal history, neonatal morbidities and birth defects were assessed in the neonates of 292 diabetic mothers. Independent t-test and binary logistic regression were performed to determine the association of various risk factors with neonatal morbidities and with birth defects. Results: 94 (32%) infants had neonatal morbidities. 26 (9%) of them had severe morbidities. Mean third trimester HbA1c was 5.9%. Infants with neonatal morbidity had statistically higher mean third trimester HbA1c level (6.45 ± 1.36%) compared to infants without neonatal morbidity (5.53 ± 0.97%), p = 0.003. Every 1% increase in HbA1c increases the odds of having neonatal morbidity by 2.2 times (p <0.001). Third trimester HbA1c <6.5% will not affect the odds of having neonatal morbidities. 10 (3%) infants had major birth defects (including neural tube defects, congenital heart disease, various syndromes, perineal malformation). 27 (9%) had minor birth defects. There was no significance between pregestational HbA1c and birth defects. Conclusions: Despite good antenatal glycaemic control, current antenatal practices for GDM is suboptimal as evidenced by the high incidence of neonatal morbidity. Universal screening, emphasis on maternal education, accessible assessment tools and stricter glycaemic control (HbA1c <6.3) will lead to a better pregnancy outcome. Further studies documenting similar neonatal outcomes will make a stronger case for a review of the national guidelines. 2018 Thesis http://eprints.usm.my/45735/ http://eprints.usm.my/45735/1/Dr%20Muhammad%20Yusoff-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RG Gynecology and obstetrics
spellingShingle	RG Gynecology and obstetrics Ramdzan, Muhammad Yusoff Mohd A cross-sectional study on neonatal morbidities and birth defects in diabetic pregnancies in Malaysia : a single hospital study
description	Background: National data regarding the neonatal outcome of infants of diabetic mothers is lacking despite Malaysia having one of the highest incidences of diabetic pregnancies in the region. This study aimed to describe the various neonatal morbidities and birth defects in infants of diabetic mothers and analyse their risk factors. Methods: In this cross-sectional, descriptive study spanning four months, antenatal history, neonatal morbidities and birth defects were assessed in the neonates of 292 diabetic mothers. Independent t-test and binary logistic regression were performed to determine the association of various risk factors with neonatal morbidities and with birth defects. Results: 94 (32%) infants had neonatal morbidities. 26 (9%) of them had severe morbidities. Mean third trimester HbA1c was 5.9%. Infants with neonatal morbidity had statistically higher mean third trimester HbA1c level (6.45 ± 1.36%) compared to infants without neonatal morbidity (5.53 ± 0.97%), p = 0.003. Every 1% increase in HbA1c increases the odds of having neonatal morbidity by 2.2 times (p <0.001). Third trimester HbA1c <6.5% will not affect the odds of having neonatal morbidities. 10 (3%) infants had major birth defects (including neural tube defects, congenital heart disease, various syndromes, perineal malformation). 27 (9%) had minor birth defects. There was no significance between pregestational HbA1c and birth defects. Conclusions: Despite good antenatal glycaemic control, current antenatal practices for GDM is suboptimal as evidenced by the high incidence of neonatal morbidity. Universal screening, emphasis on maternal education, accessible assessment tools and stricter glycaemic control (HbA1c <6.3) will lead to a better pregnancy outcome. Further studies documenting similar neonatal outcomes will make a stronger case for a review of the national guidelines.
format	Thesis
qualification_level	Master's degree
author	Ramdzan, Muhammad Yusoff Mohd
author_facet	Ramdzan, Muhammad Yusoff Mohd
author_sort	Ramdzan, Muhammad Yusoff Mohd
title	A cross-sectional study on neonatal morbidities and birth defects in diabetic pregnancies in Malaysia : a single hospital study
title_short	A cross-sectional study on neonatal morbidities and birth defects in diabetic pregnancies in Malaysia : a single hospital study
title_full	A cross-sectional study on neonatal morbidities and birth defects in diabetic pregnancies in Malaysia : a single hospital study
title_fullStr	A cross-sectional study on neonatal morbidities and birth defects in diabetic pregnancies in Malaysia : a single hospital study
title_full_unstemmed	A cross-sectional study on neonatal morbidities and birth defects in diabetic pregnancies in Malaysia : a single hospital study
title_sort	cross-sectional study on neonatal morbidities and birth defects in diabetic pregnancies in malaysia : a single hospital study
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2018
url	http://eprints.usm.my/45735/1/Dr%20Muhammad%20Yusoff-24%20pages.pdf
_version_	1747821554600771584

A cross-sectional study on neonatal morbidities and birth defects in diabetic pregnancies in Malaysia : a single hospital study

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