- Maternal diabetes mellitus (DM) is associated with increased risk for persistent pulmonary hypertension of the newborn (PPHN).
- For babies with refractory hypoxemia born to mothers with diabetes, PPHN should be considered.
Why this matters
- PPHN is a major cause of respiratory failure and even death in neonates.
- Systematic review identified 5 observational cohort and 2 case-control studies, including 5083 PPHN cases.
- Funding: National Natural Science Foundation of China; Beijing Municipal Administration of Hospital’s Youth Program; others.
- PPHN incidence was approximately 0.2% and significantly higher (~6%) among preterm infants with gestational age
- Compared with mothers without diabetes, pooled adjusted risk ratio (aRR) for PPHN for mothers with diabetes (either preexisting or gestational) was 1.37 (95% CI, 1.23-1.51).
- Association was significant in case-control studies (aRR, 1.91; 95% CI, 1.02-2.79) and in cohort studies (aRR, 1.36; 95% CI, 1.22-1.50).
- After exclusion of a single study of extremely preterm infants, a significant association between maternal diabetes and PPHN persisted among the 6 studies of late-preterm infants (aRR, 1.42; 95% CI, 1.28-1.56), with no evidence of heterogeneity.
- Potential for selection bias.
- Missing information on variables such as weight, medications, lifestyle.
- Varying degree of confounder adjustment across studies.