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. 2024 Jul 1;47(7):1194-1201.
doi: 10.2337/dc23-2239.

Risk of Neonatal Hypoglycemia in Infants of Mothers With Gestational Glucose Intolerance

Chloe Andrews  1 , Jacqueline Maya  2   3   4 , Carolin C M Schulte  5   6 , Sarah Hsu  2   7 , Tanayott Thaweethai  4   5 , Kaitlyn E James  4   8 , Jose Halperin  4   9 , Camille E Powe  2   4   8 , Sarbattama Sen  1   4
Affiliations

Risk of Neonatal Hypoglycemia in Infants of Mothers With Gestational Glucose Intolerance

Chloe Andrews et al. Diabetes Care. .

Abstract

Objective: To examine the relationship between gestational glucose intolerance (GGI) and neonatal hypoglycemia.

Research design and methods: This was a secondary analysis of 8,262 mother-infant dyads, with delivery at two hospitals between 2014 and 2023. We categorized maternal glycemic status as normal glucose tolerance (NGT), GGI, or gestational diabetes mellitus (GDM). We defined NGT according to a normal glucose load test result, GGI according to an abnormal glucose load test result with zero (GGI-0) or one (GGI-1) abnormal value on the 100-g oral glucose tolerance test, and GDM according to an abnormal glucose load test result with two or more abnormal values on the glucose tolerance test. Neonatal hypoglycemia was defined according to blood glucose <45 mg/dL or ICD-9 or ICD-10 diagnosis of neonatal hypoglycemia. We used logistic regression analysis to determine associations between maternal glucose tolerance category and neonatal hypoglycemia and conducted a sensitivity analysis using Δ-adjusted multiple imputation, assuming for unscreened infants a rate of neonatal hypoglycemia as high as 33%.

Results: Of infants, 12% had neonatal hypoglycemia. In adjusted models, infants born to mothers with GGI-0 had 1.28 (95% 1.12, 1.65), GGI-1 1.58 (95% CI 1.11, 2.25), and GDM 4.90 (95% CI 3.81, 6.29) times higher odds of neonatal hypoglycemia in comparison with infants born to mothers with NGT. Associations in sensitivity analyses were consistent with the primary analysis.

Conclusions: GGI is associated with increased risk of neonatal hypoglycemia. Future research should include examination of these associations in a cohort with more complete neonatal blood glucose ascertainment and determination of the clinical significance of these findings on long-term child health.

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Conflict of interest statement

Duality of Interest. J.H. is a founder and has financial interest in Mellitus. Mellitus had licensed related intellectual property and has interests in developing diagnostic tools for diabetes. C.E.P. receives payments from Wolters Kluwer for UpToDate chapters on diabetes in pregnancy and has received payments for consulting and speaking from Mediflix. S.S. received devices from Dexcom for a research study at no cost. The interests of J.H. and S.S. were reviewed and are managed by BWH and Brigham Health in accordance with their conflict of interest policies. No other potential conflicts of interest relevant to this article were reported.

Figures

None
Graphical abstract
Figure 1
Figure 1
Frequency of neonatal hypoglycemia. Shown are results for the entire cohort (A), by gestational glucose tolerance category (B), and by GGI category (C).
Figure 2
Figure 2
Odds of neonatal hypoglycemia by maternal glucose tolerance category (A) and maternal glucose tolerance category subtypes (B). Reference category is NGT. Associations adjusted for maternal age, parity, and BMI. n = 7,963. Points, ORs; horizontal lines, 95% CIs; blue line, OR of 1.0.
See this image and copyright information in PMC

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