Neonatal hypoglycemia after initiation of late preterm antenatal corticosteroids

doi:10.1038/s41372-020-0589-1

. 2020 Sep;40(9):1339-1348.

doi: 10.1038/s41372-020-0589-1. Epub 2020 Feb 14.

Neonatal hypoglycemia after initiation of late preterm antenatal corticosteroids

Kristen R Uquillas¹, Richard H Lee², Smeeta Sardesai³, Ellison Chen⁴, Ugonna Ihenacho⁵, Victoria K Cortessis^{5

6}, Lorayne Barton³

Affiliations

¹ Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Kristen.Uquillas@med.usc.edu.
² Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
³ Division of Neonatology, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁴ Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁵ Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁶ Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

PMID: 32060360
DOI: 10.1038/s41372-020-0589-1

Neonatal hypoglycemia after initiation of late preterm antenatal corticosteroids

Kristen R Uquillas et al. J Perinatol. 2020 Sep.

. 2020 Sep;40(9):1339-1348.

doi: 10.1038/s41372-020-0589-1. Epub 2020 Feb 14.

Authors

Kristen R Uquillas¹, Richard H Lee², Smeeta Sardesai³, Ellison Chen⁴, Ugonna Ihenacho⁵, Victoria K Cortessis^{5

6}, Lorayne Barton³

Affiliations

¹ Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Kristen.Uquillas@med.usc.edu.
² Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
³ Division of Neonatology, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁴ Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁵ Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁶ Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

PMID: 32060360
DOI: 10.1038/s41372-020-0589-1

Abstract

Objective: To compare the frequency and severity of neonatal hypoglycemia in pregnancies treated with and without late preterm antenatal corticosteroids.

Study design: We conducted a retrospective cohort study of late preterm deliveries at LAC + USC (2015-2018). Neonatal outcomes were compared between pregnancies treated with and without corticosteroids.

Results: 93 pregnancies (39.9%) received corticosteroids and 140 (60.1%) did not. Neonates born to women given corticosteroids were more likely to be hypoglycemic (47.3 vs. 29.3%, OR_adj 2.25, p_adj = 0.01). The mean initial glucose (45.6 mg/dL vs. 51.9 mg/dL, p = 0.01) and glucose nadir (39.1 mg/dL vs. 45.4 mg/dL, p < 0.001) were significantly lower if the neonates received corticosteroids. Neonates admitted to the NICU solely for hypoglycemia were more likely to be born to women treated with corticosteroids (OR_adj 4.71, p_adj = 0.01).

Conclusion: Administration of late preterm corticosteroids was associated with an increased incidence and severity of neonatal hypoglycemia.

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References

1. Gilstrap LC, Christensen R, Clewell WH, D'Alton ME, Davidson Jr EC, Escobedo MB, et al. Effect of corticosteroids for fetal maturation on perinatal outcomes. NIH consensus development panel on the effect of corticosteroids for fetal maturation on perinatal outcomes. JAMA 1995;273:413–18.
1. Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2017;3:CD004454. - PubMed
1. Escobar GJ, Clark RH, Greene JD. Short-term outcomes of infants born at 35 and 36 weeks gestation: we need to ask more questions. Semin Perinatol. 2006;30:28–33. - DOI
1. Gyamfi-Bannerman C, Thom EA, Blackwell SC, Tita AT, Reddy UM, Saade GR, et al. Antenatal betamethasone for women at risk for late preterm delivery. N Engl J Med. 2016;374:1311–20. - DOI
1. Committee on Obstetric Practice. Committee opinion no. 713: antenatal corticosteroid therapy for fetal maturation. Obstet Gynecol. 2017;130:e102–9. - DOI

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[1] Gilstrap LC, Christensen R, Clewell WH, D'Alton ME, Davidson Jr EC, Escobedo MB, et al. Effect of corticosteroids for fetal maturation on perinatal outcomes. NIH consensus development panel on the effect of corticosteroids for fetal maturation on perinatal outcomes. JAMA 1995;273:413–18.

[2] Gilstrap LC, Christensen R, Clewell WH, D'Alton ME, Davidson Jr EC, Escobedo MB, et al. Effect of corticosteroids for fetal maturation on perinatal outcomes. NIH consensus development panel on the effect of corticosteroids for fetal maturation on perinatal outcomes. JAMA 1995;273:413–18.

[3] Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2017;3:CD004454. - PubMed

[4] Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2017;3:CD004454. - PubMed

[5] Escobar GJ, Clark RH, Greene JD. Short-term outcomes of infants born at 35 and 36 weeks gestation: we need to ask more questions. Semin Perinatol. 2006;30:28–33. - DOI

[6] Escobar GJ, Clark RH, Greene JD. Short-term outcomes of infants born at 35 and 36 weeks gestation: we need to ask more questions. Semin Perinatol. 2006;30:28–33. - DOI

[7] Gyamfi-Bannerman C, Thom EA, Blackwell SC, Tita AT, Reddy UM, Saade GR, et al. Antenatal betamethasone for women at risk for late preterm delivery. N Engl J Med. 2016;374:1311–20. - DOI

[8] Gyamfi-Bannerman C, Thom EA, Blackwell SC, Tita AT, Reddy UM, Saade GR, et al. Antenatal betamethasone for women at risk for late preterm delivery. N Engl J Med. 2016;374:1311–20. - DOI

[9] Committee on Obstetric Practice. Committee opinion no. 713: antenatal corticosteroid therapy for fetal maturation. Obstet Gynecol. 2017;130:e102–9. - DOI

[10] Committee on Obstetric Practice. Committee opinion no. 713: antenatal corticosteroid therapy for fetal maturation. Obstet Gynecol. 2017;130:e102–9. - DOI

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Neonatal hypoglycemia after initiation of late preterm antenatal corticosteroids

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Neonatal hypoglycemia after initiation of late preterm antenatal corticosteroids

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