Management of infants born to mothers with gestational diabetes. Paediatric environment.

OBJECTIVE

To evaluate the modalities of neonatal care for cases of treated and untreated gestational diabetes mellitus (GDM).

METHODS

A search of the PubMed database was performed and recommendations from the National Institute for Health and Clinical Excellence and the French National Authority for Health were consulted.

RESULTS

There were no paediatric indications for birth to take place in a specialised facility, except in cases of severe foetal growth abnormality, major malformations or risk of premature birth. Systematic blood glucose monitoring is recommended for newborns of mothers with insulin-treated GDM, or infants considered large or small for gestational age. Systematic blood glucose monitoring is not recommended for infants of mothers with diet-controlled GDM, or in the absence of growth abnormalities. Newborns should undergo routine neonatal icterus monitoring. Measurement of calcium levels and a complete blood count (CBC) should be carried out when clinically appropriate. Complementary testing for the detection of heart, bone or brain defects should be performed according to clinical signs. The indications for transferring infants of mothers with GDM to a neonatal intensive care unit are the same as for all other newborns.

CONCLUSIONS

Newborns can be cared for in general maternity wards, except in cases of premature birth, major malformations or severe foetal growth abnormalities. The management of newborns of mothers with GDM, particularly in the prevention, detection and management of hypoglycaemia, is improved through the existence of a written protocol.