Maternal glucose response to betamethasone administration

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Endocrinology

Background:

• Betamethasone is a corticosteroid commonly used to promote fetal lung maturation in preterm pregnancies.
• Antenatal corticosteroid therapy can impact maternal glucose metabolism.
• Understanding maternal glucose response is vital for optimizing obstetric care.

Purpose of the Study:

• To characterize the temporal pattern of maternal glucose fluctuations following betamethasone administration.
• To quantify hyperglycemia in pregnant women using continuous glucose monitoring (CGM) after betamethasone.
• To assess glucose response in both diabetic and nondiabetic pregnant individuals.

Main Methods:

• A prospective observational trial involving pregnant women (24-34 weeks gestation) receiving betamethasone.
• Continuous glucose monitoring devices were used to measure interstitial fluid glucose every 5 minutes for up to 7 days.
• Analysis focused on the percentage of time glucose levels remained above predefined thresholds (110, 144, 180 mg/dL).

Main Results:

• Data from 15 participants (11 nondiabetic, 4 diabetic) were analyzed.
• Peak maternal hyperglycemia occurred between 24 and 48 hours post-betamethasone injection in both groups.
• Nondiabetic women spent a significant percentage of time above glucose thresholds: 73% (>110 mg/dL), 40% (>144 mg/dL), and 17% (>180 mg/dL).

Conclusions:

• Betamethasone administration induces notable maternal hyperglycemia, particularly in nondiabetic women.
• Close maternal glucose monitoring is recommended when delivery is imminent following betamethasone therapy.
• Proactive management of maternal hyperglycemia may mitigate risks of neonatal hypoglycemia.