387 Hypoglycemia on oral glucose tolerance test during pregnancy and risk for the small neonate

Abstract

Hypoglycemia in oral glucose tolerance test (OGTT) may indicate maternal hyperinsulinemia and abnormal glucose metabolism . We aimed to evaluate maternal characteristics and neonatal birthweight in pregnancies with hypoglycemia on 100 grams OGTT. A retrospective cohort analysis of all live-born deliveries in one medical center in 2018-2019 with available OGTT results and birth outcomes. Preterm deliveries (<34 weeks), multiple pregnancies and major anomalies were excluded. Hypoglycemia was defined as at least one glucose value lower than 60 mg/dl. Maternal characteristics and perinatal outcomes were compared between 3 groups: Hypoglycemia on OGTT, Normal OGTT and abnormal OGTT, defined as at least one abnormal value according to Carpenter & Coustan thresholds. Parturient with abnormal OGTT and any hypoglycemic value were considered in the abnormal GTT group. Univariate followed by multivariate analysis was utilized to control for confounders. Overall, 2,079 met inclusion criteria and entered analysis. Cohort included 216(10.4%) OGTT's with at least one hypoglycemic value, 1,072(51.6%) normal OGTT's and 719(34.6%) abnormal OGTT's (Fig1-Average values). In over 90% (198/216) of cases, hypoglycemic values appeared 3H following sugar load. Rates of nulliparity were lowest in the hypoglycemia group despite similar maternal age as the normoglycemic. hypoglycemia was associated with fetal male gender and abnormal OGTT was associated with lower PAPP-A levels. Absolute birthweight, low birth weight and small for gestational age differed between groups, however, there was no difference between groups in birth weight percentiles (60.1±26.8 vs. 63±26 vs. 60.9±27, p>0.05, local sex-specific curves). Also, following adjustment to confounders (maternal age, BMI, nulliparity, any hypertensive disorder) hypoglycemia did not appear to affect rates of low birth weight or small for gestational age (p<0.05). There were no other differences in birth outcomes between groups. According to our study, hypoglycemia in OGTT is not associated with maternal or neonatal adverse outcomes.View Large Image Figure ViewerDownload Hi-res image Download (PPT)