title: Hyperglycemia and adverse pregnancy outcome study: neonatal glycemia.
abstract: OBJECTIVE
  The goal was to describe the temporal pattern of neonatal plasma glucose levels and associations with maternal glucose levels, cord serum C-peptide levels, and neonatal size and adiposity.
  
  
  METHODS
  A total of 17,094 mothers and infants were included in the Hyperglycemia and Adverse Pregnancy Outcome Study (15 centers in 9 countries). Mothers underwent a 75-g, 2-hour, oral glucose tolerance test (OGTT) at 24 to 32 weeks of gestation. Cord blood and neonatal blood samples were collected. Biochemical neonatal hypoglycemia was defined as glucose levels of <10th percentile (2.2 mmol/L). Clinically identified hypoglycemia was ascertained through medical record review and associations were assessed.
  
  
  RESULTS
  Plasma glucose concentrations were stable during the first 5 hours after birth. Maternal glucose levels were weakly positively associated with biochemical neonatal hypoglycemia (odds ratios: 1.07-1.14 for 1-SD higher OGTT glucose levels). Frequency of neonatal hypoglycemia was higher with higher cord C-peptide levels (odds ratio: 11.6 for highest versus lowest C-peptide category). Larger and/or fatter infants were more likely to have hypoglycemia (P < .001), and infants with hypoglycemia tended to have a higher frequency of cord C-peptide levels of >90th percentile.
  
  
  CONCLUSIONS
  Mean neonatal plasma glucose concentrations varied little in the first 5 hours after birth, which suggests normal postnatal adjustment. Biochemical and clinical hypoglycemia were weakly related to maternal OGTT glucose measurements but were strongly associated with elevated cord serum C-peptide levels. Larger and/or fatter infants were more likely to develop hypoglycemia and hyperinsulinemia. These relationships suggest physiologic relationships between maternal glycemia and fetal insulin production.
authors.affiliation: Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA. bem@northwestern.edu
authors.forename: Boyd E
authors.initials: BE
authors.lastname: Metzger
authors.forename: Bengt
authors.initials: B
authors.lastname: Persson
authors.forename: Lynn P
authors.initials: LP
authors.lastname: Lowe
authors.forename: Alan R
authors.initials: AR
authors.lastname: Dyer
authors.forename: J Kennedy
authors.initials: JK
authors.lastname: Cruickshank
authors.forename: Chaicharn
authors.initials: C
authors.lastname: Deerochanawong
authors.forename: Henry L
authors.initials: HL
authors.lastname: Halliday
authors.forename: Anselm J
authors.initials: AJ
authors.lastname: Hennis
authors.forename: Helen
authors.initials: H
authors.lastname: Liley
authors.forename: Pak C
authors.initials: PC
authors.lastname: Ng
authors.forename: Donald R
authors.initials: DR
authors.lastname: Coustan
authors.forename: David R
authors.initials: DR
authors.lastname: Hadden
authors.forename: Moshe
authors.initials: M
authors.lastname: Hod
authors.forename: Jeremy J N
authors.initials: JJ
authors.lastname: Oats
authors.forename: Elisabeth R
authors.initials: ER
authors.lastname: Trimble
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications*; D007003:Hypoglycemia / Q000097:blood / Q000209:etiology; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood / Q000209:etiology*; D007328:Insulin / Q000097:blood*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011256:Pregnancy Outcome; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin