Trajectory of serum bilirubin in offspring of women with gestational diabetes mellitus

Aims: To investigate the trajectory of bilirubin from birth to the first 48 h of life in neonates of women with gestational diabetes. Methods: In a cohort of 69 neonates of women with gestational diabetes, delivered at Policlinic Abano, Abano Terme, Italy, from October 2021 to May 2022, we conducted a case-control study (1:2 ratio) on total serum bilirubin (TSB) trajectory over the first 48 h after birth. An ancillary analysis was conducted on arterial cord blood gas analysis at birth and on concurrent hemoglobin, hematocrit, lactate, glycemia, and bilirubin levels. Results: The neonates of women with gestational diabetes showed a significantly higher mean percent variation of TSB from birth to the first 48 h of life (p = 0.01), a finding supported by a higher, although not significant, TSB levels at 48 h of life in comparison to controls (8.05 +/- 4.8 vs 8.05 +/- 4 mg%, p = 0.082), and by a significantly lower cord TSB levels (2.3 +/- 0.9 vs 2.6 +/- 0.9 mg%, p = 0.010). Conclusions: The findings suggest that future primary studies on hyperbilirubinemia risk in neonates of women with gestational diabetes should consider the trajectory of TSB beyond the first 48 h, adjusting for a more complete set of pre-pregnancy and gestational prognostic risk factors.