Vol. 6, Issue 2, Part D (2024)

Importance: Iron is an important micronutrient and iron deprivation in utero or in early infancy can result in neurodevelopmental deficits and behavioural abnormalities in the child. This study draws a comparison between the iron status of neonate born to diabetic mothers with controlled and uncontrolled diabetic status. 
Objective: To assess the relationship between HbA1c status of mother and iron profile of neonate of diabetic mother at the time of delivery.
Design: Observational study
Study Setting: Labour room, postnatal ward of Obstetrics & Gynaecology department, Inborn Intensive care unit and nursery, Government TD medical college, Alappuzha.
Study Population: All neonates of diabetic mothers born in Government T D Medical College; Alappuzha will be enrolled in the study.
Study Duration: 18 months from December 3rd, 2019
Inclusion criteria: Neonates born to diabetic mothers who were on medical nutrition therapy or treatment with oral hypoglycaemic agents/ insulin irrespective of maternal diabetic control. 
Method: Based on the HbA1c status of the diabetic mothers in the last trimester, they were arbitrarily divided into good control and poorly controlled diabetes and was compared with iron status of the baby immediately after birth which was tested using cord blood.
Result: Comparison was made between two groups, one with maternal HbA1c ≤ 6.5%; other with maternal HbA1c > 6.5%. First group contained 57 samples. Second group contained 34 samples. On comparing the iron status between those babies born to mothers with HbA1c >6.5% and ≤6.5%, Ferritin (Mean 92.4 vs 211nanogram per millilitre) as well as serum Iron (Mean 83 vs 143microgram per decilitre) was found to be lower in babies of mothers with overt diabetes and these were statistically significant with 95% confidence interval.
Conclusion: Maternal diabetes causes lowering of fetal iron stores which was seen more with babies born to mothers with poorly controlled diabetes. Therefore, proper dietary as well as medical management of maternal diabetes is essential for maintaining iron stores in the baby even though other factors influence. This is a novel study comparing the relationship between ‘glycaemic status’ of the mother with iron profile of neonate. Further follow up studies may be needed for evaluating the effects of abnormal iron profile of newborn at birth born to mothers with poorly controlled diabetes and whether these can be prevented by early iron administration.