Neonatal hypoglycaemia in early preterm infants exposed to antenatal steroid therapy in pregnant mothers with diabetes: a retrospective cohort study

Objective To compare the incidence of neonatal hypoglycaemia (NH) in early preterm infants born to mothers with diabetes who were exposed to antenatal corticosteroids (ACS) and those born to mothers without diabetes who were also exposed to ACS. Study Methods A retrospective cohort study of pregnant mothers who delivered between 28 0/7 and 33 6/7 weeks of gestation who had received ACS. All deliveries were at Columbia University Medical Centre, a tertiary care centre in the city of New York. ACS doses and timing of administration prior to delivery were compared between primary exposure groups, mothers diagnosed with diabetes versus mothers without diabetes. The primary outcome was NH (<40 mg/dL) within the first 48 hours of life. Associations were tested using χ 2 test and logistic regression. Results Of 212 eligible patients, neonates of mothers with diabetes demonstrated a higher rate of NH (39.4% vs 19.6%, p=0.01). Other risk factors of NH included maternal body mass index and maternal age at delivery. Steroid dose and timing of administration were not determinant factors in developing NH. Conclusions Early preterm neonates of mothers with diabetes who received ACS have a higher risk of NH. However, due to the lack of a control group of unexposed infants, the direct impact of ACS on NH cannot be conclusively determined.