Rachel K Harrison1, Vishmayaa Saravanan2, Caroline Davitt2, Meredith Cruz2, Anna Palatnik3. 1. Maternal Fetal Medicine, Advocate Medical Group, 4400W. 95th St, Suite 207, Chicago, IL, 60453, USA. 2. Department of Obstetrics and Gynecology, Medical College of Wisconsin, 9200W. Wisconsin Ave, Milwaukee, WI, 53226, USA. 3. Department of Obstetrics and Gynecology, Medical College of Wisconsin, 9200W. Wisconsin Ave, Milwaukee, WI, 53226, USA. apalatnik@mcw.edu.
Abstract
OBJECTIVE: To examine the prevalence of antenatal maternal hypoglycemia after initiation of pharmacotherapy for gestational diabetes mellitus (GDMA2) and its association with pregnancy outcomes. STUDY DESIGN: Retrospective cohort of GDMA2 women receiving either insulin or oral hypoglycemic agents. Composite neonatal outcome included macrosomia, jaundice, respiratory distress syndrome, large for gestational age, shoulder dystocia, birth trauma, 5-minute Apgar < 7, and neonatal hypoglycemia, and was compared between women with and without hypoglycemia using bivariate and multivariate analyses. RESULTS: Of 489 women included in the study, 95 (19.4%) had at least one episode of hypoglycemia, most often in the setting of glyburide. Newborns exposed to maternal hypoglycemia had higher rates of the composite neonatal outcome (54.7% vs. 38.3%, p = 0.004). After controlling for confounding factors, maternal hypoglycemia remained independently associated with the composite neonatal outcome (aOR = 1.69, 95% CI 1.04-2.72). CONCLUSION: Maternal hypoglycemia in GDMA2 was associated with higher rates of adverse neonatal outcomes.
OBJECTIVE: To examine the prevalence of antenatal maternal hypoglycemia after initiation of pharmacotherapy for gestational diabetes mellitus (GDMA2) and its association with pregnancy outcomes. STUDY DESIGN: Retrospective cohort of GDMA2 women receiving either insulin or oral hypoglycemic agents. Composite neonatal outcome included macrosomia, jaundice, respiratory distress syndrome, large for gestational age, shoulder dystocia, birth trauma, 5-minute Apgar < 7, and neonatal hypoglycemia, and was compared between women with and without hypoglycemia using bivariate and multivariate analyses. RESULTS: Of 489 women included in the study, 95 (19.4%) had at least one episode of hypoglycemia, most often in the setting of glyburide. Newborns exposed to maternal hypoglycemia had higher rates of the composite neonatal outcome (54.7% vs. 38.3%, p = 0.004). After controlling for confounding factors, maternal hypoglycemia remained independently associated with the composite neonatal outcome (aOR = 1.69, 95% CI 1.04-2.72). CONCLUSION: Maternal hypoglycemia in GDMA2 was associated with higher rates of adverse neonatal outcomes.
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