Prospective study on influence of perinatal factors on the development of early neonatal hypoglycemia in late preterm and term infants

Ruiz, Nuria Martín; Íñiguez, J.P. García; Gracia, Segundo Rite; Villagrasa, María Pilar Samper

doi:10.1016/j.anpede.2021.04.007

Cited by 5 publications

(5 citation statements)

References 30 publications

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“…The improvement in neonatal weight appeared to be one of the benefits of reduction for the fetus, consistent with the literature [18].The incidence of neonatal hypoglycemia was significantly different between the two groups. Twin pregnancy is a risk factor for neonatal hypoglycemia [19]. This study suggests that the incidence of neonatal hypoglycemia is higher in triplet pregnancy than in twin pregnancy.…”

Section: P R E P R I N Tmentioning

confidence: 62%

Maternal and fetal benefits of fetal reduction in triplet pregnancies

Zhang

et al. 2023

Arch Med Sci

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IntroductionTriplet pregnancy is a type of high-risk pregnancy that often results in premature delivery. Although fetal reduction is recommended, a number of factors can lead to triplet pregnancies without reduction. As there is no consensus on reduction, it is necessary to carry out a specific evaluation of the benefits of reduction in triplet pregnancy. This study was performed to evaluate and discuss the prognosis of triplet pregnancy with or without fetal reduction.Material and methodsClinical data from 24 women with triplet pregnancies were retrospectively collected and analyzed. Twelve women underwent fetal reduction (fetal reduction group) and 12 women continued triplet pregnancy (non-fetal reduction group). In the fetal reduction group, four dichorionic triamniotic triplets were reduced to dichorionic diamniotic twins (with a reduction of one of the monochorionic diamniotic fetuses); six trichorionic triamniotic triplets were reduced to dichorionic diamniotic twins (with a reduction of one monochorionic monoamniotic fetus).ResultsThere were significant differences in the incidence of premature rupture of membranes and neonatal hypoglycemia between the reduction and non-reduction groups. The average birth weight was significantly different between the reduction group and non-reduction group. The Apgar score was significantly different between the monochorionic monoamniotic reduction group and monochorionic diamniotic reduction group.ConclusionsTriplet pregnancy should be closely monitored throughout pregnancy and the perinatal period, regardless of fetal reduction. The chorionicity should be considered with fetal reduction. Compared with the mother, the remaining fetuses may benefit more from fetal reduction, especially in terms of neonatal weight.

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Section: P R E P R I N Tmentioning

confidence: 62%

Maternal and fetal benefits of fetal reduction in triplet pregnancies

Zhang

et al. 2023

Arch Med Sci

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“…In terms of the the other at-risk group, the best threshold was 3.950 mmol/L and the NPV was 0.908. When umbilical cord blood glucose levels are above the cutoff value, a high negative predictive value indicates that it is possible to reduce interventions and glucose tests among this population, helping doctors and healthcare providers make more accurate diagnostic and treatment decisions [ 27 ]. However, the relatively low incidence of hypoglycemia may affect the results of negative predictive value.…”

Section: Discussionmentioning

confidence: 99%

Umbilical artery cord blood glucose predicted hypoglycemia in gestational diabetes mellitus and other at-risk newborns

Wang,

Liu,

Zhang

et al. 2023

BMC Endocr Disord

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Background To explore the value of umbilical artery cord blood glucose (UACBG) in predicting hypoglycemia in gestational diabetes mellitus (GDM) and other at-risk newborns, and to provide a cut-off UACBG value for predicting hypoglycemia occurrence. Methods In this prospective study, we enrolled at-risk infants delivered vaginally, including neonates born to mothers with GDM, premature, macrosomic, and low birth weight. We separated the infants into GDM group and other at-risk group. All subjects underwent UACBG measurement during delivery. Neonatal peripheral blood glucose measurement was performed at 0.5 and 2 h after birth. The predictive performance of UACBG for neonatal hypoglycemia was assessed using receiver operating characteristic curve (ROC), area under curve (AUC), sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV). Results 916 newborns were included, with 538 in GDM group and 378 in other at-risk group. 85 neonates were diagnosed hypoglycemia within 2 h after birth, including 36 belonging to GDM group and 49 to other at-risk group. For hypoglycemia prediction within 2 h, the best cut-off of UACBG was 4.150 mmol/L, yielding an AUC of 0.688 (95% CI 0.625–0.751) and a NPV of 0.933. In detail, the AUC was 0.680 in GDM group (95% CI 0.589–0.771), with the optimal cut-off of 4.150 mmol/L and a NPV of 0.950. In other at-risk group, the AUC was 0.678(95% CI 0.586–0.771), the best threshold was 3.950 mmol/L and the NPV was 0.908. No significant differences were observed between GDM group and other at-risk group in AUC at 0.5 h, 2 h and within 2 h. Conclusions UACBG has a high NPV for predicting neonatal hypoglycemia within 2 h after birth. It was implied that individuals with cord blood glucose levels above the threshold were at lower risk for hypoglycemia. UACBG monitoring provides evidence for subsequent classified management of hypoglycemia.

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“…However, we met the call for the development of a measurement non-invasively and painlessly evaluating glucose levels accurately in neonates. Second, considering the effect of cesarean delivery on the odds of neonatal hypoglycemia [40], only vaginal delivery was included, which also increases the reliabiliy of our ndings. Third, given the differences in post-delivery breast feeding, formula milk supplementation, and early skin to skin contact among newborns in different medical institutions, we explored the predictive value of at 0.5 h and 2 h respectively, making it possible to diagnose neonatal hypoglycemia and take interventions in time to avoid later neurodevelopmental disorders.…”

Section: Discussionmentioning

confidence: 99%

Umbilical Artery Cord Blood Glucose Predicted hypoglycemia in Gestational Diabetes Mellitus and Other at-risk Newborns

Wang

Liu

Zhang

et al. 2022

Preprint

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Backgrounds: To explore the value of umbilical artery cord blood glucose (UACBG) in predicting hypoglycemia in gestational diabetes mellitus (GDM) and other at-risk newborns, and to provide a cut-off UACBG value for predicting hypoglycemia occurrence. Methods: In this prospective study, we enrolled at-risk infants delivered vaginally, including neonates born to mothers with GDM, premature, macrosomia, and low birth weight. We separated the infants into GDM group and other at-risk group. All subjects underwent UACBG measurement during delivery. Neonatal peripheral blood glucose measurement was performed at 0.5 hand 2 h after birth. The predictive performance of UACBGfor neonatal hypoglycemia was assessed using receiver operating characteristic curve (ROC), area under curve (AUC), sensitivity and specificity. Results: 916 newborns were included, 538 in GDM group and 378 in other at-risk group. For hypoglycemia prediction within 2 h, the best cut-off of UACBG was 4.150 mmol/L, yielding an AUC of 0.688 (95% CI 0.625-0.751). UACBG had a better performance at 0.5 h (AUC 0.757; 95% CI 0.690-0.824). In detail, the AUC was 0.703 in GDM group (95% CI 0.594-0.811), with the optimal cut-off of 4.550 mmol/L. In other at-risk group, the AUC was 0.797（95% CI 0.716-0.877), and the best threshold was 4.350 mmol/L. No significant differences were observed between GDM group and other at-risk group in AUC at 0.5 h, 2 h and within 2 h. Conclusions: UACBG may be an efficient, non-invasive approach to predicting neonatal hypoglycemia within 2 h after birth.

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Prospective study on influence of perinatal factors on the development of early neonatal hypoglycemia in late preterm and term infants

Cited by 5 publications

References 30 publications

Maternal and fetal benefits of fetal reduction in triplet pregnancies

Maternal and fetal benefits of fetal reduction in triplet pregnancies

Umbilical artery cord blood glucose predicted hypoglycemia in gestational diabetes mellitus and other at-risk newborns

Umbilical Artery Cord Blood Glucose Predicted hypoglycemia in Gestational Diabetes Mellitus and Other at-risk Newborns

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