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Q&A

Diabetes

Poster Session 2

(542) Association Between Maternal Hypoglycemia Using Continuous Glucose Monitoring and Adverse Pregnancy Outcomes

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

    Primary & Presenting Author(s)

  • Sarah Nazeer, MD (she/her/hers)

    Maternal-Fetal Medicine Fellow
    McGovern Medical School at UTHealth Houston
    Houston, TX, United States

    • Coauthor(s)

  • RS

    Rafael Santos, PhD

    McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
    Houston, TX, United States

  • CP

    Claudia Pedroza, PhD

    McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
    Houston, TX, United States

  • SB

    Sean C. Blackwell, MD

    Professor
    Children's Memorial Hermann Hospital
    Houston, TX, United States

  • Baha M. Sibai, MD

    Professor
    Hermann Memorial Hospital
    Houston, TX, United States

  • Michal Fishel Bartal, MD (she/her/hers)

    Maternal Fetal Medicine Faculty
    McGovern Medical School at UTHealth Houston, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
    Houston, TX, United States

Objective:

Several studies suggest a correlation between hypoglycemia and outcomes related to placental insufficiency or those related to elevated blood sugars. We aimed to examine the association between time below range (TBR) continuous glucose monitor (CGM) metrics and adverse perinatal outcomes among individuals using CGM during gestational diabetes (GDM) screening.

Study Design:

This was a secondary analysis of a prospective study (06/2020 to 01/2022) of individuals who underwent 2-step GDM screening at ≤ 30 weeks. Participants wore a blinded CGM (Dexcom G6 Pro) for ten days at time of 1-hour glucose challenge test (GCT). We evaluated TBR defined as the percentage of time less than 63 mg/dL. The primary outcome was a composite of adverse maternal and neonatal outcomes indicative of placental insufficiency, including preterm birth, placental abruption, hypertensive disorders of pregnancy, small for gestational age (defined as < 10th percentile on the Duryea et al nomogram), and neonatal death. Secondary outcomes included other neonatal and maternal outcomes. TBR was expressed as a percentage of all CGM readings and mean glucose were analyzed.  Pearson’s Chi-squared and Fisher’s exact test were calculated; p value of < 0.05 was considered as a statistically significant value.

Results:

Of the 92 individuals recruited, the total median time below range was 0.5% (IQR, 0.1, 1.2), with a median of 0.3% (IQR 0.0, 1.5) during daytime and 0.1% (0.0, 1.2) nocturnal TBR. CGM indicated 30 individuals (36.7%) had TBR < 1%, and 63 individuals (67.4%) had TBR >1%. Individuals with TBR >1 % did not have an increased risk of either adverse composite placental insufficiency outcome (p=0.59), or other neonatal adverse outcomes (Table). 

Conclusion:

In this prospective study using CGM we did not find an association between maternal TBR and adverse neonatal or maternal outcomes. Larger studies are needed to investigate whether hypoglycemia in pregnancy is associated with adverse perinatal outcomes.