Risk of hypoglycemia by anthropometric measurements in neonates of mothers with diabetes

Bouchghoul, Hanane; Mokhtari, Delphine Mitanchez; Letourneau, Alexandra; Bouyer, Jean; Sénat, Marie-Victoire

doi:10.1007/s00431-022-04532-6

Cited by 6 publications

(2 citation statements)

References 35 publications

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“…Several studies have reported that the incidence of hypoglycemia is high in neonates with macrosomia. [36][37][38] Said et al 4 showed that hypoglycemia was common in infants born via C-section. Further, it might be caused by delayed feeding initiation and intravenous therapy after birth.…”

Section: Discussionmentioning

confidence: 99%

Association between maternal factors and fetal macrosomia in full-term singleton births

Chen

Chang

et al. 2023

Journal of the Chinese Medical Association

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Background: Macrosomia, defined as a birth weight of ≥4000 g, is associated with a high risk of birth injury. Fetal growth is highly correlated with maternal conditions, and several maternal factors are associated with neonatal birth size. The current study aimed to assess maternal factors related to fetal macrosomia in a Taiwanese population. Methods: The medical records of pregnant mothers and their newborns were retrospectively reviewed. All singleton pregnancies delivered at and after 37 weeks of gestation were included in the analysis. Maternal and neonatal conditions were evaluated according to different birth weights. Results: A total of 4262 infants were enrolled in our study. The mean birth weight was 3156 ± 383 g, including 77 (1.8%) cases with birth weight ≥4000 g, and 154 (3.6%) infants with birth weight <2500 g. The mean maternal body weight before delivery was 67.6 ± 10.0 kg. The mean 6-month gestational weight gain (6mGWG) was 12.3 ± 4.2 kg, and the mean maternal body mass index (BMI) was 26.2 ± 3.6 kg/m2. The maternal weight, height, and 6mGWG, gestational age, and placental weight were significantly positively correlated with neonatal birth weight. The odds ratios of macrosomia were 3.1 in neonates born to mothers with a 6mGWG of ≥15 kg, 6.3 in those born to mothers with gestational diabetes mellitus, and 4.1 in those born to mothers with a BMI of ≥30 kg/m2. Newborn macrosomia was associated with adverse events in pregnant mothers and newborn infants. Conclusion: Gestational diabetes mellitus, 6mGWG, and maternal BMI are significantly correlated with neonatal macrosomia in full-term singleton births. Further, neonatal macrosomia is an important cause of maternal and neonatal morbidity. Hence, pregnant women should undergo maternal counseling for weight management before and during pregnancy, and the appropriate delivery method should be identified to prevent perinatal adverse events.

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Section: Discussionmentioning

confidence: 99%

Association between maternal factors and fetal macrosomia in full-term singleton births

Chen

Chang

et al. 2023

Journal of the Chinese Medical Association

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“…Previous studies have focused on the risk factors, management and prognosis of NH, the majority of which were focused on secondary prevention ( 12 – 15 ). An early identification tool to identify NH high-risk groups is lacking ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Development of a prediction model for neonatal hypoglycemia risk factors: a retrospective study

et al. 2023

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BackgroundIt’s challenging for healthcare workers to detect neonatal hypoglycemia due to its rapid progression and lack of aura symptoms. This may lead to brain function impairment for the newborn, placing a significant care burden on the family and creating an economic burden for society. Tools for early diagnosis of neonatal hypoglycemia are lacking. This study aimed to identify newborns at high risk of developing neonatal hypoglycemia early by developing a risk prediction model.MethodsUsing a retrospective design, pairs (470) of women and their newborns in a tertiary hospital from December 2021 to September 2022 were included in this study. Socio-demographic data and clinical data of mothers and newborns were collected. Univariate and multivariate logistic regression were used to screen optimized factors. A neonatal hypoglycemia risk nomogram was constructed using R software, and the calibration curve and receiver operator characteristic curve (ROC) was utilized to evaluate model performance.ResultsFactors integrated into the prediction risk nomogram were maternal age (odds ratio [OR] =1.10, 95% CI: 1.04, 1.17), fasting period (OR=1.07, 95% CI: 1.03, 1.12), ritodrine use (OR=2.00, 95% CI: 1.05, 3.88), gestational diabetes mellitus (OR=2.13, 95% CI: 1.30, 3.50), gestational week (OR=0.80, 95% CI: 0.66, 0.96), fetal distress (OR=1.76, 95% CI: 1.11, 2.79) and neonatal body mass index (OR=1.50, 95% CI: 1.24, 1.84). The area under the curve (AUC) was 0.79 (95% confidence interval [CI]: 0.75, 0.82), specificity was 0.82, and sensitivity was 0.62.ConclusionThe prediction model of this study demonstrated good predictive performance. The development of the model identifies advancing maternal age, an extended fasting period before delivery, ritodrine use, gestational diabetes mellitus diagnosis, fetal distress diagnosis and an increase in neonatal body mass index increase the probability of developing neonatal hypoglycemia, while an extended gestational week reduces the probability of developing neonatal hypoglycemia.

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Umbilical artery cord blood glucose predicted hypoglycemia in gestational diabetes mellitus and other at-risk newborns

Wang,

Liu,

Zhang

et al. 2023

BMC Endocr Disord

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Background To explore the value of umbilical artery cord blood glucose (UACBG) in predicting hypoglycemia in gestational diabetes mellitus (GDM) and other at-risk newborns, and to provide a cut-off UACBG value for predicting hypoglycemia occurrence. Methods In this prospective study, we enrolled at-risk infants delivered vaginally, including neonates born to mothers with GDM, premature, macrosomic, and low birth weight. We separated the infants into GDM group and other at-risk group. All subjects underwent UACBG measurement during delivery. Neonatal peripheral blood glucose measurement was performed at 0.5 and 2 h after birth. The predictive performance of UACBG for neonatal hypoglycemia was assessed using receiver operating characteristic curve (ROC), area under curve (AUC), sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV). Results 916 newborns were included, with 538 in GDM group and 378 in other at-risk group. 85 neonates were diagnosed hypoglycemia within 2 h after birth, including 36 belonging to GDM group and 49 to other at-risk group. For hypoglycemia prediction within 2 h, the best cut-off of UACBG was 4.150 mmol/L, yielding an AUC of 0.688 (95% CI 0.625–0.751) and a NPV of 0.933. In detail, the AUC was 0.680 in GDM group (95% CI 0.589–0.771), with the optimal cut-off of 4.150 mmol/L and a NPV of 0.950. In other at-risk group, the AUC was 0.678(95% CI 0.586–0.771), the best threshold was 3.950 mmol/L and the NPV was 0.908. No significant differences were observed between GDM group and other at-risk group in AUC at 0.5 h, 2 h and within 2 h. Conclusions UACBG has a high NPV for predicting neonatal hypoglycemia within 2 h after birth. It was implied that individuals with cord blood glucose levels above the threshold were at lower risk for hypoglycemia. UACBG monitoring provides evidence for subsequent classified management of hypoglycemia.

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Risk of hypoglycemia by anthropometric measurements in neonates of mothers with diabetes

Cited by 6 publications

References 35 publications

Association between maternal factors and fetal macrosomia in full-term singleton births

Association between maternal factors and fetal macrosomia in full-term singleton births

Development of a prediction model for neonatal hypoglycemia risk factors: a retrospective study

Umbilical artery cord blood glucose predicted hypoglycemia in gestational diabetes mellitus and other at-risk newborns

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