INTRODUCTION:
There are recommendations regarding target antepartum and intrapartum blood glucose values, but associations between degree of glucose control and neonatal hypoglycemia are not well-studied. We researched these factors and the rates of neonatal hypoglycemia in women with gestational and pre-gestational diabetes (DM).
METHODS:
This was a retrospective cohort study of all women diagnosed with gestational diabetes and pre-gestational DM at ≥23 weeks gestational age who delivered at an urban institution from 2016 to 2017. Our primary outcome was neonatal hypoglycemia defined as neonatal blood glucose <40 mg/dL. Antepartum glucose control categories were as follows: good (90% fingersticks within target range, compliant with prenatal care (PNC)), moderate (50-90% fingersticks within target range, compliant with PNC), poor (<50% of fingersticks within target range or missed 3+ prenatal visits). Intrapartum glucose control within target range were categorized as either never controlled or controlled the entire labor course.
RESULTS:
Of 191 neonates, 46 had hypoglycemia, resulting in a rate of 24%. Cases with neonatal hypoglycemia compared to cases without neonatal hypoglycemia were less likely to have good antenatal glucose control (17% vs. 29-34%; P=.048). Good intrapartum glucose control was not associated with neonatal hypoglycemia (P=.403).
CONCLUSION:
In our cohort of women with diabetes, we found that good antenatal glucose control, compared to moderate or poor, was associated with a decreased rate of neonatal hypoglycemia. This finding can be used for counseling and encourage women to better control their blood glucose values. More research is needed regarding the effect of intrapartum glucose control on neonatal hypoglycemia.
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