Neonatal Hypoglycemia following Late Preterm Antenatal Corticosteroid Administration in Individuals with Diabetes in Pregnancy.

OBJECTIVE

Antenatal corticosteroid (ACS) administration is standard practice for pregnant individuals delivering in the late preterm period, though no guidelines are in place for those with diabetes. This study aims to characterize the prevalence of neonatal hypoglycemia after ACS administration in pregnant individuals with diabetes delivering in the late preterm period.

STUDY DESIGN

This is a retrospective, single-center, case-control study of individuals with diabetes who delivered between 34 and 36 weeks' gestation at a large academic medical center from 2016 to 2021. A total of 169 individuals were included in the analysis; 87 received corticosteroids and 82 did not. The proportion of neonates with hypoglycemia, neonatal intensive care unit (NICU) admission, respiratory distress syndrome, and hyperbilirubinemia were compared between parents who received ACSs versus those who did not.

RESULTS

The prevalence of neonatal hypoglycemia (40.2 vs. 23.2%,  = 0.027), requiring treatment (40.3 vs. 22.4%,  = 0.041), and hyperbilirubinemia (35.6 vs 18.5%,  = 0.018) was greater for neonates born to individuals with diabetes who received late preterm ACSs compared with those who did not. There was no difference in NICU admission and respiratory distress between the groups. These results remained unchanged after controlling for confounders including gestational age at delivery and birth weight.

CONCLUSION

This study demonstrates that late preterm corticosteroid administration to pregnant individuals with diabetes increases the risk for neonatal hypoglycemia without changing the rates of respiratory morbidity.

KEY POINTS

· Late preterm ACS in diabetic patients resulted in higher rates of neonatal hypoglycemia.. · There are no differences in rates of respiratory distress syndrome and transient tachypnea of the newborn between the ACS group and control group.. · There was no noted difference in rate of NICU admission and length of stay between the two groups..