This retrospective study analyzed 477 cases of neonatal hypoglycemia over one year and compared maternal glycemic parameters to neonatal outcomes. 33.1% of mothers had abnormal glucose challenge test (GCT) screens while there was no significant difference between those with abnormal GCTs and one or two abnormal oral glucose tolerance tests. Babies born to mothers with abnormal GCTs had lower birth weights but no differences in APGAR scores or C-section rates. The study concludes that abnormal GCTs can identify mothers at risk of having babies with hypoglycemia and higher risks of obesity, and that earlier detection of at-risk mothers could help reduce NICU admissions and long-term childhood obesity.

1. Retrospective Analysis of Neonatal Hypoglycemia
and Its Relationship to Maternal Parameters
V. Lozovyy MD, A. Filshtinsky BS, J. King BS, F. Schubert MPH, G. Gowda MD, D. Contreras MD, S. Singh MD
Department of Obstetrics and Gynecology, NYU Lutheran Medical Center, Brooklyn, NY
Introduction
Infants of the diabetic mother carry an increased risk
of neonatal morbidity as a direct result of poor
maternal glycemic control during the antenatal
period. Clinically significant neonatal hypoglycemia
(NH) occurs in infants with impaired adaptation
mechanisms to varying maternal factors during the
antenatal period.
The goal of the study was to determine the incidence
of unsuspected neonatal hypoglycemia in the well-
baby nursery in comparison to maternal glycemic
parameters during pregnancy.
Results
Overall, 477 cases of neonatal hypoglycemia were
identified in a 1year period. A total of 470 GCT
values were retrieved from maternal records, of
which 158 (33.1%) mothers exhibited abnormal
GCT screen. A total of 137 OGTT were retrieved
(86.7%) The normal GCT group differed from the
abnormal GCT group in birth weight (3.3kg vs
3.5kg p=.004), no significant differences were
found among abnormal GCT group and those
mothers with one or two abnormal values of OGTT
screen. There was no significant difference in
mean APGARS at 1 and 5 minutes respectively
were 8.4 (SD 1.3) and 8.9 (SD 0.6). There were no
differences in C-section rates between any groups.
Strengths & Limitations
• Small sample size
• Retrospective study
Conclusions
Mothers with abnormal GCT screen were not
different from women with one or two abnormal
OGTT values. Abnormal GCT identified women
with early insulin resistance and neonates born to
them are at risk for hypoglycemia and adiposity.
Earlier detection of mothers at risk of having a
neonate with hypoglycemia is of paramount
importance. Additional research will be needed to
further identify characteristics these women share.
Additionally we can potentially decrease or
eliminate NICU admissions which are costly and
long term help decrease adiposity, which leads to
childhood obesity.
Methods
This was a retrospective cohort study of 477 infants
identified with incidental hypoglycemia (glucose <45
mg/dL) from June 2014 to July 2015 requiring entry
into the hypoglycemia protocol for 24 hour monitoring
after birth. Maternal glycemic and biometric
parameters were reviewed and matched accordingly.
Chi-squared and independent samples t-tests were
used to determine whether there were significant
differences in neonatal outcome between women with
1 hour abnormal glucose challenge test post 50 Gm.
Load (GCT) compared to those with one or two
abnormal GTT values post 100Gm. load.
Differences in neonatal outcome were compared
between women with abnormal GCT vs. one or two
abnormal values of OGTT (Carpenter and Coustan
criteria)
P < 0.05 was considered significant
Neonatal and Maternal
characteristics
Outcome (n)
Average maternal
GCT
127±36 (392)
Maternal GCT < 135 66.3% (312)
Maternal GCT > 135 33.1% (158)
Maternal GCT > 135
and
≤1 abnormal OGTT
8.2% (39)
Maternal GCT > 135
and
≥2 abnormal OGTT
11% (119)
Gestational age in
weeks
38±2 (280)
NICU admissions 5.5% (26)
Neonatal glucose 40.2±4.2 (477)
Cohort Outcome (n)
APGAR @
1 minute
GCT < 135 8.4±1.3 (380)
GCT > 135 8.4±1.4 (38)
APGAR @
5 minutes
GCT < 135 8.9±0.6 (380)
GCT > 135 8.9±0.3 (38)
Neonatal
weight
GCT < 135 3.3±0.8 (235)
GCT > 135 3.5±0.6 (153)
Cesarean
Sections
GCT < 135 47%
GCT > 135 56%
Vaginal
Deliveries
GCT < 135 53%
GCT > 135 44%
Table 2: Statistics of individual cohorts
Table 1: Statistics of entire study