Comparative Evaluation of Neonatal Outcomes among Macrosomic Infants Born to Diabetic and Non-Diabetic Mothers

Open Access

Abstract

Background: Fetal macrosomia is associated with increased neonatal morbidity and mortality, particularly among infants born to diabetic mothers. Maternal diabetes contributes to fetal hyperinsulinemia and excessive fetal growth, which may worsen neonatal complications. Aim of the study: To compare neonatal outcomes among macrosomic infants born to diabetic and non-diabetic mothers. Methods & Materials: This retrospective comparative study was conducted in a tertiary care hospital in Bangladesh over 12 months and included 108 macrosomic neonates with birth weight ≥4000 g. Participants were divided into diabetic mothers with macrosomic infants (n=38) and non-diabetic mothers with macrosomic infants (n=70). Maternal characteristics, delivery outcomes, neonatal complications, duration of hospital stay, and predictors of NICU admission were analyzed using SPSS version 26.0. Result: Diabetic mothers had significantly higher maternal age, BMI, parity, and cesarean section rates compared with non-diabetic mothers. Neonates born to diabetic mothers showed significantly higher rates of NICU admission (52.63% and 14.29%, p<0.001), transient tachypnea of the newborn (21.05% and 2.86%, p=0.012), and hypoglycemia (26.32% and 7.14%, p=0.004). Mean hospital stay was also significantly prolonged among infants of diabetic mothers (4.8±1.6 and 3.2±1.1 days, p<0.001). Birth trauma-related complications showed no statistically significant difference between groups. Multivariate logistic regression identified maternal diabetes, birth weight >4000 g, and gestational age <39 weeks as independent predictors of NICU admission. Conclusion: Macrosomic infants born to diabetic mothers are at substantially increased risk of metabolic and respiratory complications, prolonged hospitalization, and NICU admission. Strict antenatal glycemic control, appropriate obstetric management, and vigilant neonatal surveillance are essential to improve neonatal outcomes in diabetic pregnancies complicated by macrosomia.