Risk Factors for Neonatal Hypoglycemia Following Exposure to Antenatal Corticosteroids [14D

Abstract

INTRODUCTION: To quantify the influence of maternal and neonate characteristics on risk of neonatal hypoglycemia in pregnancies exposed to antenatal steroids (ANCS). METHODS: We performed a retrospective cohort study utilizing a 2013-2017 dataset created from electronic medical records (EPIC) of all mothers who delivered early (<34) and late preterm (34 to <37 weeks) at the University of Cincinnati, linked to neonatal data through 1 week postdelivery. Maternal and neonatal characteristics were compared between preterm neonates exposed to ANCS experiencing hypoglycemia and those with normal glycemic levels. Multivariate logistic regression estimated the relative risk of these factors on the risk of neonatal hypoglycemia following preterm ANCS. RESULTS: 1,210 mother-neonate pairs were included. Hypoglycemia, defined as neonatal BG of <40 mg/dL in the first week of life, was present in 24.0% of early preterm births (PTBs) and 24.4% of late PTBs exposed to ANCS. The factor most strongly associated with neonatal hypoglycemia was maternal hyperglycemia (BG ≥180mg/dL) on the day of or day prior to delivery. This association was stronger in late PTBs (adjusted relative risk [adjRR] 4.49; 95% CI 1.50, 13.40) than early PTBs (adjRR 1.91; 95% CI 1.07, 3.41). CONCLUSION: The presence of maternal hyperglycemia proximate to time of delivery (0-1 days prior to birth) is the most predictive factor for neonatal hypoglycemia, with magnitude of risk higher in late preterm compared to early preterm neonates This information demonstrates the importance of maternal glycemic control near the time of delivery after exposure to ANCS.