title: Neonatal chemical hypoglycemia in newborns from pregnancies complicated by type 2 and gestational diabetes mellitus - the importance of neonatal ponderal index.
abstract: OBJECTIVE
  To determine the frequency and risk factors associated with neonatal chemical hypoglycemia in neonates of mothers with type 2 diabetes and gestational diabetes mellitus (GDM).
  
  
  METHODS
  A retrospective cohort study of women with type 2 diabetes or GDM and their singleton neonates. The primary outcome measure was the presence of neonatal chemical hypoglycemia (capillary plasma equivalent glucose <45 mg/dl) within 1 h of birth. Statistical methods included bivariate and multivariate analyses.
  
  
  RESULTS
  242 mother infant dyads were identified. Sixty-eight (28%) were treated with diet, 110 (46%) with glyburide, and 64 (26%) with insulin. The incidence of neonatal chemical hypoglycemia was 18% (44/242). The incidence was significantly higher in those requiring pharmacotherapy (25% vs. 3%, p < 0.001). The frequency of neonatal chemical hypoglycemia between the glyburide and insulin-treated pregnancies did not differ significantly (23% vs. 27%, p = 0.58). The frequency of neonatal chemical hypoglycemia was statistically associated with birth weight, macrosomia and ponderal index (p < 0.001). Neonatal ponderal index was the strongest predictor of hypoglycemia (adjusted Odds ratio 5.59).
  
  
  CONCLUSIONS
  Neonatal chemical hypoglycemia occurs more frequently in infants from women with type 2 diabetes and GDM treated with glyburide or insulin. An increased neonatal ponderal index is a strong predictor of significant neonatal chemical hypoglycemia.
authors.affiliation: Department of Reproductive Medicine, University of California, San Diego, CA, USA. gramos@ucsd.edu
authors.forename: Gladys A
authors.initials: GA
authors.lastname: Ramos
authors.forename: Alethea A
authors.initials: AA
authors.lastname: Hanley
authors.forename: Jennifer
authors.initials: J
authors.lastname: Aguayo
authors.forename: Carri R
authors.initials: CR
authors.lastname: Warshak
authors.forename: Jae H
authors.initials: JH
authors.lastname: Kim
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Moore
mesh_terms: D001724:Birth Weight; D001786:Blood Glucose / Q000032:analysis; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D016640:Diabetes, Gestational / Q000188:drug therapy; D005260:Female; D005865:Gestational Age; D005905:Glyburide / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007231:Infant, Newborn / Q000097:blood; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000188:drug therapy; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D005905:Glyburide