Newborn infants of overtly diabetic mothers are often overweight, appear cushingoid, and have increased deposits of adipose tissue. All organs are enlarged, except the brain, and the pancreatic islets of Langerhans are hyperplastic. Approximately 35% of such infants die in utero or in the neonatal period. In prediabetic women and women with latent diabetes, perinatal loss is also increased. Because appropriate care during the gestational period may improve fetal survival, identification of such women is obviously important.
One approach to this problem is reported in a recent issue of the Archives of Pathology.1 In this study organ abnormalities of stillborn and newborn infants were used to identify mothers with previously unrecognized disturbances in glucose metabolism. Adrenal gland enlargement and pancreatic islet hyperplasia were the most characteristic features of such infants. Using these two morphologic abnormalities as criteria, the authors reviewed autopsy files, selecting 17 newborn infants whose mothers were