94 - Oral Feeding in Infants Born to Mothers with Diabetes

Poster Number: 94
Publication Number: 94.252

Background: Dysphagia is described in infants born to mothers with diabetes (IDM), which has been associated with maldeveloped vagal neuropathy. Clinically, it is widely believed that IDMs (Group 1) take longer to achieve oral feeding goals than their counterparts born to mothers without diabetes (Group 2). However, there have been no studies performed to date to evaluate if and how much is the difference.

Objective: Compare the time to establish oral feeding in infants born to mothers with diabetes compared to infants born to mothers without diabetes.

Design/Methods: This is an IRB approved retrospective study of electronic medical records of infants born at more than 34 weeks gestational age and admitted (1/1/2020 to 01/31/2022) to the neonatal intensive care unit (NICU) at the University of Missouri Women’s Hospital in Columbia, Missouri. Exclusion criteria included death, premature birth at less than 34 weeks, encephalopathy, genetic disorders, cleft palate, and transfer to another hospital for further care. Time to full oral feedings was calculated from the date oral feeding was allowed to the date 150ml/kg/day of oral feeds were consumed. Continuous variables were analyzed with the Mann Whitney U test. Binomial variables were analyzed with the Chi-Square test. Propensity score matching and linear regression analysis were performed using SPSS version 28 (IBM SPSS Statistics, IBM Corporation, Armonk, NY). A p-value of < 0.05 was used to define statistical significance.

Results: Univariate analysis on the entire cohort and cohort more than 37 weeks (but not in the less than 37 weeks cohort) gestational age at birth revealed a mean difference of two days to establish full oral feedings between the two groups (p=0.0001 Figure 1). Linear regression (LR) in the entire cohort revealed that maternal diabetes and birth weight more than 4000gm were associated with longer time to PO feeds (Figure 2A). LR in IDMs revealed higher maternal body mass index and pregestational diabetes were associated with longer time to PO feeds (Figure 2B). The linear regression run on 1:1 propensity score matched cohort of 452 babies revealed statistically significant association between maternal diabetes and longer time to full oral feeds (p=0.039) (Figure 2C).

Conclusion(s): IDMs take an average of two additional days to achieve oral feeding goals than infants born to mothers without diabetes (p=0.01). Maternal pregestational diabetes, increased maternal BMI, infant birth weight more than 4000g, and decreasing gestational age increase the time to full feeds by mouth. This data can be used to counsel mothers with diabetes.