Abstract
Background: To investigate the blood glucose level response of diabetic pregnant women when administrating antenatal dexamethasone to accelerate fetal lung maturity in different routes. Methods: This prospective cohort study included 60 pregnant women with diabetes who required promotion of fetal lung maturity in Peking University First Hospital from January 2013 to April 2015. Dexamethasone was administered by IM (n = 29) or IAC (n = 31). Blood glucose level was monitored before injection, and 1 day, 2 days and 3 days after injection. Results: In the intramuscular injection group, the preprandial and postprandial blood glucose concentration was significantly elevated in the first two days (P < 0.001), and the postprandial blood glucose level was still higher than basal level (P = 0.034) on the third day. In the intra-amniotic injection group, the preprandial and postprandial blood glucose concentration was also significantly elevated on the first day (P < 0.001), but soon returned to the basal level on the second day. No significant difference was found in the magnitude of glucose increase between the two groups. Conclusion: Blood glucose level is significantly influenced by intramuscular injection of antenatal dexamethasone rather than amniotic cavity injection.
Highlights
Pregnancy with diabetes is composed of pre-gestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM)
The level of postprandial blood glucose has been remarkably elevated on the first day in both groups (1.38 ± 1.15 mmol/L vs. 1.34 ± 1.26 mmol/L) after dexamethasone injection when compared with the pre-injection level (P < 0.001)
It is verified by abundant large clinical trials that antenatal corticosteroid therapy is indicated for women who are at high risk of premature delivery as its effectiveness for fetal lung maturation, especially in the cases when pregnancies complicates with diabetes since fetal lung maturity is delayed in such patients
Summary
Pregnancy with diabetes is composed of pre-gestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM). Corticosteroid is an effective approach for fetal lung maturity, which can be administered either by intramuscular injection or by amniotic cavity injection. It is lack of research focusing on how and to what extent the blood glucose level differs in diabetic patients through different administration routes. This study investigates the blood glucose change due to the injection of dexamethasone, in order to reveal the impact of different administration routes on diabetic pregnant women. To investigate the blood glucose level response of diabetic pregnant women when administrating antenatal dexamethasone to accelerate fetal lung maturity in different routes. Conclusion: Blood glucose level is significantly influenced by intramuscular injection of antenatal dexamethasone rather than amniotic cavity injection
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