(450) The association between reaching glycemic goals and neonatal complications in gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is the most common complication during pregnancy. Appropriate glycemic control is mandatory to prevent maternal and neonatal complications. Daily self-monitoring blood glucose is the common method for glycemic control monitoring during GDM. It is customary to use the following glucose targets: 95 mg/dL for pre-prandial values, 130 mg/dL for 90-minute postprandial values and mean daily glucose of 100 mg/dL. Yet, those targets were calculated according to statistical measurements but an association to neonatal complications was not studied.

In the present study we examined the association between the mean daily glucose chart value and neonatal complications.

Study Design:

Retrospective observational cohort study of women with GDM who delivered between 2019 and 2021. Women were divided into groups of good and poor glycemic control, defined as a mean daily glucose of up to 100 mg/dL (N=86) and more than 100 mg/dL (N=50), respectively. The composite outcome  was defined as at least one of the following: large for gestational age, neonatal hypoglycemia, cesarean delivery due to fetal distress, neonatal jaundice treated with phototherapy, neonatal hypocalcemia and neonatal hypomagnesemia. Assuming that the rate of the composite outcome will be 10% and 30% in the good and poor glycemic control groups, respectively, a sample size of 124 women was required (5% two-sided alpha, 80% power).

Results: Data from 136 women was analyzed (table 1 and table 2). The study showed no statistical significance in the composite outcome between poor and good glycemic control. The rates of admission to the neonatal intensive care unit, respiratory distress and neonatal hospital stay were higher in the poor glycemic control group.

Conclusion: The use of the mean daily glucose values according to the daily glucose charts is limited by its ability to predict and prevent pregnancy and neonatal complications. Additional markers should be explored.