Association of Maternal Hypoglycemia on the Glucose Challenge Test and Small for Gestational Age Infants [06D

Abstract

INTRODUCTION: To determine if maternal hypoglycemia on the GCT is associated with small for gestational age (SGA) infants. The hypothesis is there will be an increased incidence of SGA in pregnancies with hypoglycemia (<88 mg/dL) as compared to euglycemia (88–129 mg/dL). METHODS: IRB approved, retrospective cohort study of singleton pregnancies from January 2015 to December 2017 with a GCT result between 24–28 weeks and delivery information were included. Patients with GCT >129 mg/dL and those with fetal anomalies were excluded. Neonatal and maternal outcomes were collected from the medical record. Growth classification was based on infant gender and gestational age at birth. Parametric and non-parametric tests, Fisher's exact and chi-squared tests were used for statistical analysis. RESULTS: 2386 patients were euglycemic (88–129 mg/dL) and 966 patients were hypoglycemic (<88 mg/dL) on the GCT results. The cohort gestational age at delivery was 39.1 weeks. Hypoglycemia was associated with increased risk for SGA infants (9.3% vs 7.0%, P=.027) and intrauterine growth restriction (IUGR) (7.9% vs 5.1%, P=.003) and less likely to have large for gestational age infant (5.1% vs 7.3%). Patients with hypoglycemia had a decreased incidence of gestational hypertension (4.8% vs. 6.7%, P=.039) and pre-eclampsia (0.8% vs. 2.2%, P=.006). CONCLUSION: Hypoglycemia (GCT level <88 mg/dL) is associated with increased risk of SGA infants and IUGR along with decreased incidence of gestational hypertension and pre-eclampsia. This information can be used to increase fetal growth surveillance by sonography in the third trimester to improve identification of SGA and IUGR.