Relative effects of antepartum and intrapartum maternal blood glucose levels on incidence of neonatal hypoglycemia.
OBJECTIVE
The objective of this study was to compare the relative effects of both antepartum and intrapartum maternal plasma glucose concentrations on neonatal plasma glucose levels.


METHODS
This was a prospective, nonrandomized study. Two hundred thirty-three pregnant insulin-requiring patients with diabetes received intensive diabetic treatment aimed at maintaining the 2-hour postprandial plasma glucose level < 150 mg/dl and the intrapartum plasma glucose level < 100 mg/dl. The neonatal plasma glucose level was monitored during the first 48 hours of life and the incidence of neonatal hypoglycemia was compared with the average antepartum and intrapartum maternal plasma glucose concentrations.


RESULTS
The lowest incidence of neonatal hypoglycemia occurred, as expected, among infants of patients who had the lowest mean antepartum and intrapartum plasma glucose levels. However, the intrapartum plasma glucose concentration had a stronger association with decreased neonatal hypoglycemia than the antepartum plasma glucose levels.


CONCLUSIONS
Even in the presence of poor antepartum diabetic control tight regulation of the intrapartum plasma glucose levels will significantly reduce the incidence of neonatal hypoglycemia.
Curet
L B
LB
University of New Mexico School of Medicine, Department of Obstetrics and Gynecology, Albuquerque 87131, USA.
Izquierdo
L A
LA
Gilson
G J
GJ
Schneider
J M
JM
Perelman
R
R
Converse
J
J
D001786:Blood Glucose / Q000032:analysis*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D008991:Monitoring, Physiologic; D010500:Perinatology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood*; D011446:Prospective Studies; D012307:Risk Factors
D001786:Blood Glucose