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. 2010 Jun;202(6):568.e1-6.
doi: 10.1016/j.ajog.2010.01.064. Epub 2010 Mar 15.

Peripartum metabolic control in gestational diabetes

Juana A Flores-Le Roux  1 , Juan J Chillaron, Alberto Goday, Jaume Puig De Dou, Antoni Paya, Maria A Lopez-Vilchez, Juan F Cano
Affiliations

Peripartum metabolic control in gestational diabetes

Juana A Flores-Le Roux et al. Am J Obstet Gynecol. 2010 Jun.

Abstract

Objective: We sought to evaluate intrapartum metabolic control in gestational diabetes mellitus (GDM) patients and maternal factors influencing intrapartum glycemic control and neonatal hypoglycemia risk.

Study design: A prospective observational study included 129 women with GDM admitted for delivery. Data collected included maternal intrapartum capillary blood glucose (CBG) and ketonemia, use of insulin, and neonatal hypoglycemia.

Results: In all, 86% of maternal intrapartum CBG values fell within target range (3.3-7.2 mmol/L) without need for insulin use. There were no cases of maternal hypoglycemia or severe ketosis. Intrapartum CBG >7.2 mmol/L was associated with third-trimester glycated hemoglobin (P = .02) and lack of endocrinologic follow-up (P = .04). Risk of neonatal hypoglycemia was related with pregnancy insulin use compared with dietary control (60.5% vs 29.5%; P = .02).

Conclusion: Peripartum metabolic control in GDM patients was achieved without insulin in most cases. Intrapartum glycemic control was related with third-trimester glycated hemoglobin and with no endocrinologic follow-up. Neonatal hypoglycemia was associated with insulin use during pregnancy.

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