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Am J Perinatol 2024; 41(S 01): e2927-e2933
DOI: 10.1055/a-2183-5062
Original Article

Neonatal Hypoglycemia following Late Preterm Antenatal Corticosteroid Administration in Individuals with Diabetes in Pregnancy

Natasha Raj-Derouin 
1   Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
,
John M. Perino
1   Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
,
Sophie Fisher
1   Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
,
Yijia Zhang
2   Department of Obstetrics and Gynecology, Vagelos College of Physician and Surgeons, Columbia University Irving Medical Center, New York, New York
3   Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
,
Vidhu Thaker
4   Division of Molecular Genetics and Pediatric Endocrinology, Department of Pediatrics, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, New York
,
Noelia M. Zork
5   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, New York
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Abstract

Objective Antenatal corticosteroid (ACS) administration is standard practice for pregnant individuals delivering in the late preterm period, though no guidelines are in place for those with diabetes. This study aims to characterize the prevalence of neonatal hypoglycemia after ACS administration in pregnant individuals with diabetes delivering in the late preterm period.

Study Design This is a retrospective, single-center, case–control study of individuals with diabetes who delivered between 340/7 and 366/7 weeks' gestation at a large academic medical center from 2016 to 2021. A total of 169 individuals were included in the analysis; 87 received corticosteroids and 82 did not. The proportion of neonates with hypoglycemia, neonatal intensive care unit (NICU) admission, respiratory distress syndrome, and hyperbilirubinemia were compared between parents who received ACSs versus those who did not.

Results The prevalence of neonatal hypoglycemia (40.2 vs. 23.2%, p = 0.027), requiring treatment (40.3 vs. 22.4%, p = 0.041), and hyperbilirubinemia (35.6 vs 18.5%, p = 0.018) was greater for neonates born to individuals with diabetes who received late preterm ACSs compared with those who did not. There was no difference in NICU admission and respiratory distress between the groups. These results remained unchanged after controlling for confounders including gestational age at delivery and birth weight.

Conclusion This study demonstrates that late preterm corticosteroid administration to pregnant individuals with diabetes increases the risk for neonatal hypoglycemia without changing the rates of respiratory morbidity.

Key Points

  • Late preterm ACS in diabetic patients resulted in higher rates of neonatal hypoglycemia.

  • There are no differences in rates of respiratory distress syndrome and transient tachypnea of the newborn between the ACS group and control group.

  • There was no noted difference in rate of NICU admission and length of stay between the two groups.

Keywords

fetal lung maturity - neonatal hypoglycemia - prematurity - respiratory distress syndrome - antenatal corticosteroids - gestational diabetes - late preterm


Publication History

Received: 16 June 2023

Accepted: 26 September 2023

Accepted Manuscript online:
28 September 2023

Article published online:
10 November 2023

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