(613) Impacts of tocolytics on maternal and neonatal glucose levels in women with gestational diabetes mellitus

Thursday, February 9, 2023

4:00 PM – 5:30 PM

Objective: We studied the impacts of tocolytic agents on maternal and neonatal blood glucose levels in women with gestational diabetes mellitus (GDM) who were admitted for preterm labor.

Study Design: This multi-center, retrospective cohort study included women with GDM who were admitted for preterm labor from twelve hospitals in South Korea. We excluded women with multiple pregnancies, women with type 2 DM, and women who received multiple types of tocolytics. The patients were divided according to the types of tocolytics; ritodrine, atosiban, and nifedipine group. We collected baseline maternal characteristics, pregnancy outcomes, maternal glucose levels during hospitalization, and neonatal glucose levels after birth. A multivariable logistic regression analysis was performed to determine associations between abnormal maternal and neonatal abnormal glucose levels and the types of tocolytics.

Results: A total of 134 women were included: 54(40.3%), 46(34.3%), and 34 (25.4%) women received ritodrine, atosiban, and nifedipine, respectively. Fasting (FPG) (111.6, 108.0, and 89.5 mg/dL, p< 0.05) and 2-hour postprandial glucose (PPG) level (145.5, 146.9, and 116.5 mg/dL, p< 0.05) were significantly higher in ritodrine, atosiban group than those in nifedipine group. Even after adjusting for covariates including steroid use, gestational age at admission, pre-pregnancy body mass index, ritodrine and atosiban were 4.9 times and 3.7 times higher in risk of high FPG (≥95mg/dL) than nifedipine group, respectively (p < 0.05). Regarding neonatal hypoglycemia ( < 50mg/dL), ritodrine and atosiban group has 5.2 and 3.9 times higher risks than nifedipine group, respectively (p < 0.05).

Conclusion: There is an increased risk of maternal hyperglycemia and neonatal hypoglycemia in women with GDM using ritodrine and atosiban tocolytics for preterm labor compared to those using nifedipine.

Presenting Author(s)

Subeen Hong, MD
Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Coauthor(s)

HS
Hyun-Joo Seol, MD, PhD
Kyung Hee University School of Medicine
Seoul, Seoul-t'ukpyolsi, Republic of Korea
JL
Joon Ho Lee, MD, PhD
Yonsei University College of Medicine, Yonsei University Health System
Seoul, Seoul-t'ukpyolsi, Republic of Korea
HH
Han Sung Hwang, MD, PhD
Konkuk University Medical Center, Konkuk University School of Medicine
Seoul, Seoul-t'ukpyolsi, Republic of Korea
JS
Ji-Hee Sung, MD
Samsung Medical Center, Sungkyunkwan University School of Medicine
Seoul, Seoul-t'ukpyolsi, Republic of Korea
JK
Ji Young Kwon, MD, PhD
Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea
Seung Mi Lee, MD, PhD
Seoul National University College of Medicine
Seoul, Seoul-t'ukpyolsi, Republic of Korea
WS
Won Joon Seong, MASTER
Kyungpook National University Hospital
Daegu, Taegu-jikhalsi, Republic of Korea
SC
Soo Ran Choi, MD, PhD
Inha University Hospital
Incheon, Republic of Korea, Republic of Korea
SK
Seung Cheol Kim, MD, PhD
Pusan National University Hospital
Pusan, Pusan-jikhalsi, Republic of Korea
HK
Hee Sun Kim, MD
Graduate School of Medicine, Dongguk University
Goyang, Kyonggi-do, Republic of Korea
SL
Se Jin Lee, MD
Kangwon National University Hospital
Seongnam-si, Kyonggi-do, Republic of Korea
SC
Sae-Kyoung Choi, MD, PhD
Obstetrics and gynecology
Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Incheon, Kyonggi-do, Republic of Korea
Kyung A Lee, MD, PhD
Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine
Seoul, Republic of Korea
HK
Hyun Sun Ko, MD, PhD
Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Primary Author(s)

Hyun Soo Park, MD, PhD, MPH
Professor
Dongguk University Ilsan Hospital
Goyang, Kyonggi-do, Republic of Korea