Disproportionate Fetal Abdominal Growth in Patients With Diabetes Does Not Increase the Risk of Neonatal Hypoglycemia [ID: 1369330

Abstract

INTRODUCTION: Neonates of pregnant persons with diabetes are at increased risk of hypoglycemia. The Fetal Abdominal Adiposity Score (FAAS) is a measure of disproportionate fetal abdominal growth theorized to serve as a proxy for fetal exposure to excess glucose in utero. We sought to characterize the relationship between FAAS and neonatal hypoglycemia in this population. METHODS: Pregnancies complicated by gestational diabetes (GDM), or preexisting diabetes type 1 (T1DM) or type 2 (T2DM), resulting in delivery of a live singleton nonanomalous fetus were identified within an existing NIH-funded database. Corresponding third-trimester ultrasounds (US) were identified. The FAAS was calculated as follows for each pregnancy, using measurements from the last US prior to delivery: fetal biparietal diameter minus fetal abdominal diameter (calculated as abdominal circumference/π). Results were expressed as a percentile for the gestational age at measurement relative to a reference population. Clinically significant neonatal hypoglycemia was defined as a hypoglycemia that either required treatment or resulted in a blood glucose level of 25 mg/dL or lower in the first 24 hours of life. RESULTS: Clinically significant hypoglycemia occurred in 58/1,299 neonates (4.5%), including 0/39 (0%) with FAAS at the 10th centile and 11/229 (4.8%) with FAAS at the 90th centile. There was no statistically significant difference in risk of hypoglycemia between various FAAS categories (P=.133). FAAS was weakly associated with the lowest postnatal blood sugar (R=0.098). CONCLUSION: Among pregnancies complicated by diabetes, FAAS was not associated with risk of neonatal hypoglycemia even for those at the extremes of abdominal growth.