Outcome of Very-Low-Birth-Weight (<1,500 Grams) Infants Born to Mothers with Diabetes
Bibliographic record
Abstract
Premature delivery is common in pregnancies complicated by maternal diabetes. However, the outcome of very-low-birth-weight infants (VLBWI) born to mothers with diabetes is not known. Employing a matched double-cohort design, we investigated the influence of maternal diabetes on the outcome of VLBWI born in Winnipeg from 1988 to 1994. We compared mortality rates and early and late morbidity rates in VLBWI born to mothers with diabetes mellitus (DM) (cases, n = 43, 23 with gestational DM and 20 with pregestational DM) and without DM (controls, n = 539). Controls were matched for gestational age (GA), sex, and the year of birth. All subjects were enrolled in the Newborn Follow-Up Program. Relative risks and 95% confidence limits were calculated for each variable and Chi 2 analysis, Student t-test, and Mann-Whitney test were used as appropriate for analysis. Diabetes mellitus control was assessed by conventional criteria. There were no differences between cases and controls in mode of delivery, birth weight (mean +/- SD, 1,160 +/- 25 g vs 1,110 +/- 26 g), GA (29 +/- 2.8 wk vs 29 +/- 2.4 wk), smallness for gestational age (35% vs 30%), head circumference (26.5 +/- 1.9 vs 26.2 +/- 2.2 cm), length (38.8 +/- 2.8 vs 37.5 +/- 3.7 cm), Apgar score < 4 at 1 min (42% vs 40%) and < 7 at 5 min (37% vs 42%). Incidence of hyaline membrane disease (60% vs 71%), bronchopulmonary dysplasia (33% vs 31%), patent ductus arteriosus (30% vs 43%), necrotizing enterocolitis (12% vs 12%), sepsis (23% vs 25%), acute renal failure (9% vs 10%), intraventricular hemorrhage--all grades (74% vs 64%), retinopathy of prematurity--all stages (30% vs 26%), median days on ventilator (4 vs 4 days), and median days on supplemental oxygen (46 vs 42 days) were similar in both groups (p = NS, 95% confidence limits included 1 for all of these variables). There was no significant difference in mortality (21% vs 15%) or the incidence of major congenital anomalies. Weight, head circumference, and length at 6, 12, and 18 months were similar in both groups. There were no group differences in developmental quotients, prevalence of neurodevelopmental impairments, respiratory morbidity, or number of hospitalizations up to the last follow-up (18 months). Our data suggest that with contemporary perinatal care there is no significant increase in mortality rates or early and late morbidity rates between VLBWI born to mothers with DM and VLBWI of nondiabetic mothers. It seems that with reasonable diabetic control, prematurity rather than the diabetic state determines the neonatal outcome, and this knowledge can be useful in parental counselling.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".