Voormolen DN, et al. - In this prospective study, experts examined the risk of neonatal hypoglycemia following diet-controlled and insulin-treated gestational diabetes mellitus (GDM) and determined how it associated with birth weight. Data reported a high incidence of both mild and severe hypoglycemia for both diet-controlled and insulin-treated GDM and across the full range of birth weight centiles through routine screening for neonatal hypoglycemia following pregnancies complicated by GDM. For neonatal hypoglycemia, routine blood glucose screening was recommended within the first 12 h of life in all neonates after GDM, regardless of maternal insulin use or birth weight.

Methods

• The scheme of this research was a prospective cohort study.
• Eligible candidates included term neonates born after GDM from January 2013 through December 2015 at the University Medical Center Utrecht (Utrecht, the Netherlands).
• At 1, 3, 6, 12, and 24 h after birth, enrollees underwent routine screening of neonatal blood glucose levels.
• Main outcome measures involved neonatal hypoglycemia defined as blood glucose ≤36 mg/dL (severe) and ≤47 mg/dL (mild).

Results

• The study cohort consisted of 506 neonates, born after pregnancies complicated by GDM treated either with insulin (22.5%) or without insulin (77.5%).
• Findings reported similar incidence of mild and severe hypoglycemia in the insulin-treated and diet-controlled groups (33 vs 35%, P=0.66; and 20 vs 21%, P=0.79).
• In 17.2% of all infants, a birth weight >90th centile was found.
• Subjects with a birth weight >90th centile were reported to have the highest risk for hypoglycemia.
• Nevertheless, the vast majority of hypoglycemia (78.6%) was identified in those with a birth weight <90th centile.
• The occurrence of over 95% of all hypoglycemia was noted within 12 h after birth.