Perinatal complications and three-year follow up of infants of diabetic mothers with diabetic nephropathy stage IV

The objective of the study was to evaluate differences in the perinatal com plications and in the 3-year follow up of infants of diabetic mothers with and without diabetic nephropathy stage IV. We compared the fetal and matern al complications and the early postpartal development until 3 years after d elivery in 10 children of nephropathic diabetic mothers and 30 children of diabetic mothers without nephropathy. The mean (+/-SD) birthweight of the i nfants of nephropathic women was 2250+/-496g versus 3544+/-435g in the wome n without nephoropathy (p < 0.01). Births were premature in six pregnancies (60%) of the nephrotic women but in none of the women without nephropathy (p < 0.01). Three infants (30%) of the women with nephropathy showed respir atory distress syndrome in contrast to two babies (6%) of the women without nephropathy. Pre-eclampsia or eclampsia occurred in 6 (60%) pregnant women with and in two women (6%) without diabetic nephropathy (p < 0.01). Nephro tic syndrome was observed in 7 nephrotic women (70%) in contrast to none wo men without nephropathy. Three years postpartum, six of the children (60%) of nephropathic women had a body weight < the 50th percentile but none of t he children of the women without nephropathy did so (p < 0.01). In addition , the children of nephropathic mothers started to speak significantly later (15 +/- 3 versus 12+/-3 months postpartum, p < 0.05) and had infectious di seases more commonly (60% versus 6%, p < 0.01) than the children of women w ithout nephropathy. It can be concluded that in pregnancies of diabetic wom en the birth weights of the infants are significantly smaller and the fetal as well as maternal complication-rates significantly higher than in those of women without nephropathy. Also 3 years after delivery, the body weight of the children of nephropathic diabetic women is significantly lower than that of children of diabetic women without nephropathy. Additionally, child ren of nephropathic women are retarded in terms of linguistic development a nd their resistance to infections is reduced.