Table 3.
In-hospital mortality and morbidities among infants born at 29 to 33 weeks’ GA by maternal insulin usea
| Outcome, N (%) | Mother received insulin (IDDM) N = 527 | Mother did not receive insulin (no IDDM) N = 6,509 | Adjusted RR (95% CI) for outcome IDDM vs. no IDDM |
|---|---|---|---|
| In hospital at 36 weeks | 303/486 (62) | 3,464/6,074 (57) | 1.06 (0.99–1.14) |
| Died before discharge | 12/527 (2) | 169/6,509 (3) | 0.72 (0.37–1.41) |
| Died ≤12 hoursb | 3/527 (0.6) | 47/6,509 (0.7) | 0.38 (0.05–2.76) |
| Infants who survived >12 hours | N = 524 | N = 6,462 | |
| Number of infants without morbidityc | 67/264 (25) | 831/3,130 (27) | 0.92 (0.75–1.12) |
| Number of infants with >1 morbidityc | 69/264 (26) | 634/3,131 (20) | 1.35 (1.08–1.68) |
| Respiratory | – | ||
| Received surfactant | 132/524 (25) | 1,680/6,461 (26) | 0.99 (0.86–1.14) |
| Respiratory support at 28 days of life | 83/503 (16) | 878/6,167 (14) | 1.19 (0.98–1.44) |
| Cardiovascular | – | ||
| PDA | 81/524 (15) | 668/6,458 (10) | 1.49 (1.20–1.85) |
| PDA treated medically only | 12/81(15) | 137/667(21) | 0.65 (0.40–1.04) |
| Surgery for PDAb | 5/81(6) | 32/667(5) | 1.46 (0.55–3.86) |
| PDA not treated | 64/81(79) | 498/667(67) | 1.05 (0.93–1.19) |
| Infection | |||
| NEC | 19/524 (4) | 150/6,455 (2) | 1.37 (0.82–2.28) |
| EOSb | 3/524 (0.6) | 47/6,460 (0.7) | 0.58 (0.15–2.27) |
| LOS | 13/520 (3) | 206/6,446 (3) | 0.60 (0.31–1.16) |
| Neurology | – | ||
| Early cranial sonogramd | 291/513 (57) | 3,760/6,379 (59) | – |
| Severe IVH | 7/289 (3) | 62/3728 (2) | 1.73 (0.79–3.76) |
| Late cranial sonograme | N = 304 | N = 3,867 | |
| PVL (at 28 days or 36 weeks)b | 10/303 (3) | 80/3,867 (2) | 1.74 (0.92–3.28) |
| Ophthalmology | – | ||
| ROP examinationf | 168/319 (53) | 2,125/3,502 (61) | – |
| ROP stage ≥ 3g | 0/167 (0) | 4/2121 (0.2) | – |
| Nutrition/growth | – | ||
| Measurements at 36 weeks | N = 432 | N = 5,342 | – |
| z-Score, mean (SD) | |||
| Weight, grams | N = 430 −0.59 (1.03) | N = 5,336 – 0.91 (0.77) | p-value < 0.001 |
| Length, cm | N = 396 −0.76 (1.07) | N = 5,015 – 0.88 (0.94) | p-value 0.001 |
| Head circumference, cm | N = 408 −0.59 (1.02) | N = 5,178 – 0.66 (0.90) | p-value 0.23 |
| Discharged at 36 weeks PMA | 176/522 (34) | 2,506/6,074 (41) | 0.92 (0.82–1.04) |
| Still in hospital at 40 weeks PMA | 50/481 (10) | 412/6,022 (7) | 1.55 (1.18–2.05) |
Abbreviations: CI, confidence interval; EOS, early-onset sepsis; IVH, intraventricular hemorrhage; LOS, late-onset sepsis; NEC, necrotizing enterocolitis; No IDDM, no insulin-dependent diabetes mellitus; PDA, patent ductus arteriosus; PMA, postmenstrual age; PVL, periventricular leukomalacia; RDS, respiratory distress syndrome; ROP, retinopathy of prematurity; RR, relative risk.
Note: All models adjusted for study center, infant gender, gestational age at birth, antenatal steroid use, maternal age, maternal race, prenatal care, multiple births, chorioamnionitis, cesarean delivery, outborn, ponderal index at birth, and delivery room interventions (CPAP vs. other), unless mentioned otherwise.
Data presented as n (%) unless otherwise specified.
Model not adjusted for center because of convergence issues.
Morbidities included RDS, PDA, NEC, sepsis, severe IVH, PVL, and ROP. Infants without an ROP exam or head ultrasound were not included in the denominator.
Early cranial sonogram included infants with ultrasounds within 28 days.
Late cranial sonogram included infants with cranial sonogram within 28 days and/or closest to 36 week PMA and after 28 days.
Includes number of infants in the hospital who received ROP exam at 28 days of life.
Adjusted analysis not performed because of no data in one of the study groups.