Renal Echo-3D and Microalbuminuria in Infants of Diabetic Mothers

Background: Infants of diabetic mothers (IDMs) face higher risks of renal developmental abnormalities and early dysfunction. Aim: This study evaluated renal cortical volume (RCV) via 3D ultrasound and microalbuminuria levels in IDMs compared to controls. Methods: We enrolled 52 full-term neonates: 30 IDMs (subdivided into pregestational diabetes mellitus [PGDM] and Gestational Diabetes Mellitus [GDM] and 22 healthy controls. All underwent clinical evaluation, 3D ultrasound for RCV measurement, and urinary microalbuminuria assessment using the Beckman nephelometric method. Maternal HbA1c and perinatal data were recorded. Results: Showed significantly lower RCV in IDMs, particularly in PGDM cases, versus controls (p < 0.001). Microalbuminuria was significantly higher in PGDM neonates (median 0.450 mg/dL) compared to controls (0.200 mg/dL, p < 0.001). RCV and microalbuminuria correlated inversely (r = -0.62, p < 0.001), while maternal HbA1c positively correlated with microalbuminuria (r = 0.65, p < 0.001). Maternal HbA1c was the strongest predictor of neonatal RCV. Conclusion: These findings indicate that maternal diabetes impairs neonatal renal development, emphasizing the need for tight glycemic control during pregnancy. Combining 3D renal ultrasound and microalbuminuria screening offers a promising non-invasive approach to early renal risk detection in IDMs.