Peripartum metabolic control in gestational diabetes.
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.


METHODS
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).


CONCLUSIONS
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.
Department of Endocrinology, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain. 94066@imas.imim.es
Juana A
JA
Flores-Le Roux
Juan J
JJ
Chillaron
Alberto
A
Goday
Jaume
J
Puig De Dou
Antoni
A
Paya
Maria A
MA
Lopez-Vilchez
Juan F
JF
Cano
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D036861:Delivery, Obstetric; D016640:Diabetes, Gestational / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000378:metabolism; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011446:Prospective Studies
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin