Abstract
Neonatal hypoclacemia (NHC) in infants of diabetic mothers (IDM) has been thought to be related to transient hypoparathyroidism or lack of responsiveness to parathyroid hormone. Previous reports of NHC in IDM have not documented its existence when compared to gestation matched infants. A previous study of low birth weight infants demonstrated the importance of early gestation on the incidence of NHC. In the present study 28 IDM were matched with infants of similar age, sex, gestation and perinatal complications. Seven IDM developed NHC compared with one in controls (p < 0.025). In IDM mean calcium levels were lower at 12, 24, 48, 60 and 72 hours of age. One IDM (maternal class D) developed temporary hypomagnesemia with NHC. During the first 3 days of life, in all infants tubular reabsorption of P (TRP) fell (93% to 87%), urinary P excretion rose (5 to 40 mg/24 hour) and urinary Ca and Mg remained low (<1 and <0.5 mg/24 hr respectively). In 6 IDM who were given PTE (5 units/kg) at 24 hours and 48 hours of age, 5 responded with temporary elevations of Ca at 12 hours post-injection compared with untreated IDM (p < 0.05). There was no significant difference in serum Mg and P levels, TRP and urinary P, Ca and Mg between treated and untreated IDM and between IDM and controls. This report demonstrates that IDM are prone to NHC, are capable of conserving Ca and Mg, and have a positive calcemic response to PTE.
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Tsang, R., Kleinman, L., Light, I. et al. The reponse to parathyroid extract (PTE) in infants of diabetic mothers (IDM). Pediatr Res 5, 393–394 (1971). https://doi.org/10.1203/00006450-197108000-00094
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DOI: https://doi.org/10.1203/00006450-197108000-00094