Does maternal hypoglycemia during screening glucose assessment identify a pregnancy at-risk for adverse perinatal outcome?

Objective: To determine the perinatal outcome in pregnancies with maternal hypoglycemia following a second trimester oral glucose challenge test (GCT).

Study Design: Retrospective case-control study of pregnancies undergoing a second trimester 1-hour oral glucose challenge test (GCT). Hypoglycemic pregnancies (<88 mg/dl) were matched with pregnancies with 1-hour glucoses of >88 mg/dl. Antepartum, intrapartum, and neonatal outcomes were assessed.

Results: Over 29 months, 334 hypoglycemic singleton pregnancies were matched with 334 controls. A greater number of special/neonatal intensive care unit (SCN/NICU) admissions occurred in the hypoglycemic group (48/334 (14.4%) vs 29/334 (8.7%) in the control group) (p=0.02). The SCN/NICU admission rate remained after controlling for maternal hypertension, smoking, and preterm birth (p=0.037). The development of pregnancy-induced hypertension in women with hypoglycemia 24/334 (7.2%) compared with euglycemic women 13/334 (3.9%, p<0.06) was not significant.

Conclusion: Admission to SCN/NICU is increased in pregnant women with hypoglycemia following a GCT.