Predictors of metabolic disorders in infants born to mothers with type 1 diabetes mellitus

Objective. To identify factors associated with the development of metabolic disorders in newborns born to mothers with type 1 diabetes mellitus (DM) and to evaluate their prognostic significance for early risk stratification.
Materials and methods. The study included 150 “mother – full-term newborn” dyads, divided into three groups of 50 pairs based on the presence and type of maternal carbohydrate metabolism disorder type diabetes: type 1 DM, gestational DM or no disorder.
Results. Analysis of the course of pregnancy revealed a significantly more severe course for women with pre-pregnancy type 1 DM (development of preeclampsia, persistent hyperglycemia despite basal-bolus insulin therapy) compared to women who developed gestational DM and those without impaired carbohydrate metabolism. Newborns of mothers with type 1 DM had all signs of diabetic fetopathy (macrosomia, various congenital heart defects, neonatal hypoglycemia), which were accompanied by morphometric changes in the hepatobiliary system. The persistence of autoantibodies against islet cells in the serum of newborns in the first group indicates active maternal disease and is an epigenetically adverse factor in the development of immune tolerance in the child’s body. 
Conclusion. Predicting the susceptibility of newborns born to mothers with type 1 DM to metabolic disorders and optimizing metabolic control will help reduce morbidity and improve the quality of life for this patient population.

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