PEDIATRICS Vol. 66 No. 3 September 1980, pp. 417-419
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Hyperbilirubinemia in Infants of Diabetic Mothers

Keith J. Peevy MD1, Stephen A. Landaw MD, PhD1, and Steven J. Gross MD1

1 Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, and the Department of Medicine, Veterans Administration and Upstate Medical Center, Syracuse, New York

Large for gestational age (LGA) infants of insulin-dependent diabetic mothers (IDM), appropriate for gestational age (AGA) IDM, and infants of nondiabetic mothers were compared for the incidence of neonatal hyperbilirubinemia and related etiologic factors. At 60 hours of age, LGA IDM had significantly higher serum bilirubin concentrations (12.3 ± 2.1 mg/100 ml) than AGA IDM (7.6 ± 3.9 mg/100 ml) or control infants (7.8 ± 2.8 mg/100 ml) (P < .001). Peak serum bilirubin concentrations were also significantly higher in LGA IDM (14.4 ± 2.1 mg/100 ml) than in AGA IDM (8.4 ± 3.7 mg/100 ml) or control infants (8.6 ± 3.3 mg/100 ml) (P < .001). Mean percent of carboxyhemoglobin was used as an indicator of hemolysis and showed a significant elevation in LGA IDM (1.51 ± 0.19) when compared to AGA IDM (1.10 ± 0.27) and control infants (1.19 ± 0.33) (P < .05). No significant differences were found among the three groups with respect to mode of delivery, frequency of pitocin administration, 5-minute Apgar scores, incidence of isoimmunization, incidence of enclosed hemorrhage, hemoglobin concentration, bilirubin concentrations at 12 hours, and percent of weight loss. Our data suggest that only LGA IDM are at increased risk for hyperbilirubinemia and that increased heme turnover is a significant factor in the pathogenesis.

Submitted on December 3, 1979
Accepted on January 14, 1980




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