Association between pregnant women fasting duration and neonatal hypoglycemia: A prospective cohort study.
hypoglycemia
neonates
prepartum fasting
prevention
women
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
Apr 2024
Apr 2024
Historique:
revised:
16
10
2023
received:
02
08
2023
accepted:
17
10
2023
medline:
18
3
2024
pubmed:
1
11
2023
entrez:
1
11
2023
Statut:
ppublish
Résumé
To evaluate the association between maternal fasting time before delivery and the occurrence of hypoglycemia in neonates immediately after birth. This prospective single-center cohort study included pregnant women who delivered at the study institution between October 2021 and January 2023 and their neonates. The primary outcome was the incidence of neonatal hypoglycemia after birth, defined as a blood glucose level less than 47 mg/dL. Fasting time was categorized into quartiles, and the association between maternal fasting time and neonatal hypoglycemia was investigated. The crude or adjusted odds ratios of maternal fasting time for neonatal hypoglycemia were calculated using logistic regression analysis. The study included 663 pregnant women and 696 neonates. Compared with the reference group with a short fasting time of 4.3 h or less, the adjusted odds ratios for neonatal hypoglycemia were 1.47 (95% confidence interval [CI] 0.70-3.20) for middle fasting time (4.3-9.8 h), 4.05 (95% CI 2.02-8.56) for long fasting time (9.8-14.6 h), and 4.99 (95% CI 2.59-10.25) for very long fasting time (>14.6 h). In the subgroup analysis, the association between maternal fasting time and neonatal hypoglycemia showed different trends according to the mode of delivery. Maternal fasting time over 9-10 h before delivery was associated with the occurrence of neonatal hypoglycemia. Obstetrical management, considering not only maternal safety but also neonatal hypoglycemia prevention, is required.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
361-367Informations de copyright
© 2023 International Federation of Gynecology and Obstetrics.
Références
Thompson-Branch A, Havranek T. Neonatal hypoglycemia. Pediatr Rev. 2017;38:147-157.
Kaiser JR, Bai S, Gibson N, et al. Association between transient newborn hypoglycemia and fourth-grade achievement test proficiency: a population-based study. JAMA Pediatr. 2015;169:913-921.
McKinlay CJD, Alsweiler JM, Anstice NS, et al. Association of neonatal glycemia with neurodevelopmental outcomes at 4.5 years. JAMA Pediatr. 2017;171:972-983.
Wickström R, Skiöld B, Petersson G, Stephansson O, Altman M. Moderate neonatal hypoglycemia and adverse neurological development at 2-6 years of age. Eur J Epidemiol. 2018;33:1011-1020.
Shah R, Harding J, Brown J, McKinlay C. Neonatal glycaemia and neurodevelopmental outcomes: a systematic review and meta-analysis. Neonatology. 2019;115:116-126.
Sharma A, Davis A, Shekhawat PS. Hypoglycemia in the preterm neonate: etiopathogenesis, diagnosis, management and long-term outcomes. Transl Pediatr. 2017;6:335-348.
Srinivasan G, Pildes RS, Cattamanchi G, Voora S, Lilien LD. Plasma glucose values in normal neonates: a new look. J Pediatr. 1986;109:114-117.
Stanley CA, Rozance PJ, Thornton PS, et al. Re-evaluating “transitional neonatal hypoglycemia”: mechanism and implications for management. J Pediatr. 2015;166:1520-1525.e1.
Isles TE, Dickson M, Farquhar JW. Glucose tolerance and plasma insulin in newborn infants of normal and diabetic mothers. Pediatr Res. 1968;2:198-208.
Grimberg A, Ferry RJ Jr, Kelly A, et al. Dysregulation of insulin secretion in children with congenital hyperinsulinism due to sulfonylurea receptor mutations. Diabetes. 2001;50:322-328.
Mendelson CL. The aspiration of stomach contents into the lungs during obstetric anesthesia. Am J Obstet Gynecol. 1946;52:191-205.
Michael S, Reilly CS, Caunt JA. Policies for oral intake during labour. A survey of maternity units in England and Wales. Anaesthesia. 1991;46:1071-1073.
Bollag L, Lim G, Sultan P, et al. Society for obstetric anesthesia and perinatology: consensus statement and recommendations for enhanced recovery after cesarean. Anesth Analg. 2021;132:1362-1377.
Clark A, Litchfield K, Hannah S, et al. Pre-operative carbohydrate loading prior to elective caesarean delivery: a randomised controlled trial. Int J Obstet Anesth. 2021;45:21-27.
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147:573-577.
Center UhMINU. UMIN Clinical Trials Registry. UMIN. Accessed 26 July, 2023. https://www.umin.ac.jp/english/
Committee on Fetus and Newborn, Adamkin DH. Postnatal glucose homeostasis in late-preterm and term infants. Pediatrics. 2011;127:575-579.
Stekhoven DJ, Bühlmann P. MissForest-non-parametric missing value imputation for mixed-type data. Bioinformatics. 2012;28:112-118.
Bujang MA, Sa'at N, Sidik T, Joo LC. Sample size guidelines for logistic regression from observational studies with large population: emphasis on the accuracy between statistics and parameters based on real life clinical data. Malays J Med Sci. 2018;25:122-130.
Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996;49:1373-1379.
Li Y, Su D, Sun Y, Hu Z, Wei Z, Jia J. Influence of different preoperative fasting times on women and neonates in cesarean section: a retrospective analysis. BMC Pregnancy Childbirth. 2019;19:104.
Grisaru-Granovsky S, Hamudi N, Samueloff A, Schimmel MS. The effect of short term maternal fasting on fetal biophysical and neonatal biochemical profile-a pilot study and a short critical review of the literature. TOWHJ. 2008;2:1-4.
Marom R, Dollberg S, Mimouni FB, et al. Neonatal blood glucose concentrations in caesarean and vaginally delivered term infants. Acta Paediatr. 2010;99:1474-1477.
He Y, Liu C, Han Y, Huang Y, Zhou J, Xie Q. The impact of oral carbohydrate-rich supplement taken two hours before caesarean delivery on maternal and neonatal perioperative outcomes-a randomized clinical trial. BMC Pregnancy Childbirth. 2021;21:682.