To identify incidence of unsuspected neonatal hypoglycemia, adverse neonatal outcome and their relationship to 50 Gm. oral glucose challenge test (GCT 135 mg/dL) and a diagnostic 100 Gm. oral glucose tolerance test (OGTT; Carpenter and Coustan criteria) in our population.METHODS:
This was a retrospective cohort study of infants identified with hypoglycemia (glucose <45 mg/dL) from 2014 to 2015 requiring entry into the protocol for 24 hours. Maternal glycemic parameters were reviewed and matched accordingly. Chi-squared and independent samples t tests were used to determine if significant differences in neonatal outcome between women with abnormal GCT compare to those with one abnormal GTT value or two abnormal GTT values.RESULTS:
Overall, 477 cases of neonatal hypoglycemia were identified and corresponding maternal data was available in 252 mothers. Abnormal GCT was observed in 33.1%, 8.2% had one abnormal value and 11% had GDM. Abnormal GCT and 1 abnormal value on GTT accounted for 31.9% and 5.5% of GDM mothers accounted for NICU admissions. The mean birth weight in abnormal GCT group was 3.5 kg. in comparison to normal GCT group (316 mothers) 3.32 kg. (P=.004). There was no difference observed in the mean APGAR scores or mode of delivery.CONCLUSION:
In our population GCT identified women with early insulin resistance and associated neonatal hypoglycemia and increased birth weight. Hence life style changes need to be implemented to decrease the NICU admissions, neonatal adiposity and childhood obesity later in life.