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Large‐for‐gestational‐age (LGA) neonate predicts a 2.5‐fold increased odds of neonatal hypoglycaemia in women with type 1 diabetes
Author(s) -
Yamamoto Jennifer M.,
KallasKoeman Melissa M.,
Butalia Sonia,
Lodha Abhay K.,
Donovan Lois E.
Publication year - 2017
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2824
Subject(s) - odds , medicine , gestational diabetes , type 2 diabetes , fold (higher order function) , odds ratio , gestational age , pediatrics , logistic regression , type 1 diabetes , diabetes mellitus , obstetrics , gestation , endocrinology , pregnancy , biology , computer science , genetics , programming language
Objective The objective of the study is to assess the impact of maternal glycaemic control and large‐for‐gestational‐age (LGA) infant size on the risk of developing neonatal hypoglycaemia in offspring of women with type 1 diabetes and to determine possible predictors of neonatal hypoglycaemia and LGA. Research methods and design This retrospective cohort study evaluated pregnancies in 161 women with type 1 diabetes mellitus at a large urban centre between 2006 and 2010. Mean trimester A 1c values were categorized into five groups. Multiple logistic regression analyses were used to examine predictors of neonatal hypoglycaemia and large‐for‐gestational‐age (LGA). Results Hypoglycaemia occurred in 36.6% of neonates. There was not a linear association between trimester specific A 1c and LGA. After adjusting for maternal age, body mass index (BMI), smoking and premature delivery, neonatal hypoglycaemia was not linearly associated with A 1c in the first, second or third trimesters. LGA was the only significant predictor for neonatal hypoglycaemia (OR, 95% CI 2.51 [1.10, 5.70]) in logistic regression analysis that adjusted for glycaemic control, maternal age, smoking, prematurity and BMI. An elevated third trimester A 1c increased the odds of LGA (1.81 [1.03, 3.18]) after adjustment for smoking, parity and maternal BMI. Conclusions Large‐for‐gestational‐age imparts a 2.5‐fold increased odds of hypoglycaemia in neonates of women with type 1 diabetes and may be a better predictor of neonatal hypoglycaemia than maternal glycaemic control. Our data suggest that LGA neonates of women with type 1 diabetes should prompt increased surveillance for neonatal hypoglycaemia and that the presence of optimum maternal glycaemic control should not reduce this surveillance. Copyright © 2016 John Wiley & Sons, Ltd.