title: Real-time continuous glucose monitoring during labour and delivery in women with Type 1 diabetes - observations from a randomized controlled trial.
abstract: OBJECTIVE
  To explore whether real-time continuous glucose monitoring during labour and delivery supplementary to hourly self-monitored plasma glucose in women with Type 1 diabetes reduces the prevalence of neonatal hypoglycaemia.
  
  
  METHODS
  Women with Type 1 diabetes participating in a randomized controlled trial on the effect of real-time continuous glucose monitoring in pregnancy were included in this study. Twenty-seven of 60 (45%) women in the intervention arm used real-time continuous glucose monitoring during labour and delivery, supplementary to hourly self-monitored plasma glucose. Real-time continuous glucose monitoring glucose data covering the last 8 h prior to delivery were retrospectively evaluated, and maternal hypo- and hyperglycaemia were defined as glucose values ≤ 3.9 mmol/l and > 7.0 mmol/l, respectively. Women in the control arm (n = 59) solely used self-monitored plasma glucose. Neonatal hypoglycaemia was defined as a 2-h plasma glucose < 2.5 mmol/l.
  
  
  RESULTS
  In infants of women using real-time continuous glucose monitoring during labour and delivery, 10 (37%) developed neonatal hypoglycaemia vs. 27 (46%) infants in the control arm (P = 0.45). Among 10 infants with and 17 infants without neonatal hypoglycaemia within the real-time continuous glucose monitoring arm, median maternal self-monitored plasma glucose was 6.2 (range 4.2-7.8) vs. 5.6 (3.3-8.5) mmol/l (P = 0.26) during labour and delivery, with maternal hyperglycaemia present in 17 (0-94) vs. 4 (0-46)% of the time (P = 0.02), and birthweight was 4040 (3102-4322) vs. 3500 (1829-4320) g (P = 0.04). Maternal hypoglycaemia up to delivery was relatively rare.
  
  
  CONCLUSIONS
  The prevalence of neonatal hypoglycaemia was comparable between infants of women using real-time continuous glucose monitoring supplementary to self-monitored plasma glucose during labour and delivery and infants of women solely using self-monitored plasma glucose.
authors.affiliation: Center for Pregnant Women with Diabetes, University of Copenhagen, Copenhagen, Denmark; Department of Endocrinology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Cordua
authors.forename: A L
authors.initials: AL
authors.lastname: Secher
authors.forename: L
authors.initials: L
authors.lastname: Ringholm
authors.forename: P
authors.initials: P
authors.lastname: Damm
authors.forename: E R
authors.initials: ER
authors.lastname: Mathiesen
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring / Q000379:methods; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis*; D007003:Hypoglycemia / Q000175:diagnosis*; D007231:Infant, Newborn; D007744:Obstetric Labor Complications / Q000175:diagnosis*; D018743:Perinatal Care; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood*; D011296:Prenatal Diagnosis / Q000379:methods; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose