CLINICAL CONFERENCE

Abstract

These infants are remarkable not only because, like foetal versions of Shadrach, Meshach and Abednego, they emerge at least alive from within the fiery metabolic furnace of diabetes mellitus, but because they resemble one another so closely that they might well be related. They are plump, sleek, liberally coated with vernix caseosa, fullfaced and plethoric. The umbilical cord and the placenta share in the gigantism. During their first 24 or more extra-uterine hours they lie on their backs, bloated and flushed, their legs flexed and abducted, their lightly closed hands on each side of the head, the abdomen prominent and their respiration sighing. They convey a distinct impression of having had such a surfeit of both food and fluid pressed upon them by an insistent hostess that they desire only peace so that they may recover from their excesses. And on the second day their resentment of the slightest noise improves the analogy while their trembling anxiety seems to speak of intra-uterine indescretions of which we know nothing. THUS Farquhar described the newly born infant of the diabetic mother. The purpose of this presentation is to review the information that is available concerning such infants and their difficulties. Dekaban and Baird, comparing 235 pregnancies in 48 diabetic mothers with 249 in paired nondiabetic controls, not only reaffirmed the increased intrauterine and neonatal mortality among these infants but also demonstrated an increased morbidity among the survivors. This morbidity included congenital malformations, retardation of development and epilepsy. Despite the increased morbidity and mortality, many of these infants are not sick and do well.