Correlation of insulin management during pregnancy and childbirth with neonatal hypoglycemia in pregnant women with diabetes

Objective To investigate the efficacy of intravenous insulin infusion for pregnant women with diabetes during childbirth for blood glucose control and the influence of diabetes management during pregnancy and childbirth on neonatal hypoglycemia.

Methods Clinical materials of 100 pregnant women with diabetes receiving antenatal care in the Department of Gynecology and Obstetrics in the Northern Jiangsu People's Hospital Affiliated to Yangzhou University from January 2022 to December 2023 were retrospectively analyzed.

Results Hypoglycemia (blood glucose < 2.2 mmol/L) was observed in 65 neonates delivered by the pregnant women, and 46 neonates delivered by the pregnant women required intravenous glucose therapy. There was a significant correlation between maternal blood glucose>7.0 mmol/L during childbirth and the occurrence of neonatal hypoglycemia (P=0.034), but these cases did not require intravenous glucose therapy or transferring to the neonatal intensive care unit. Glycated hemoglobin (HbA1c) >6.5% in the third trimester in diabetic pregnant women was correlated with the need for intervention in neonatal hypoglycemia (OR=3.89, 95%CI, 1.42 to 10.68).

Conclusion Maternal blood glucose>7.0 mmol/L during childbirth can predict neonatal hypoglycemia but is not associated with its severity. Elevated HbA1c in the third trimester reflects maternal hyperglycemia and predicts severe neonatal hyperinsulinemia with proactive interventions. Maintaining HbA1c < 6.5% in the third trimester is crucial for improving neonatal hypoglycemia.