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Correlation of maternal A1c with glucose infusion rate requirements in the newborn

K Vecera1, S Luedtke2, E Larumbe3

  • 1Department of Pharmacy, Mercy Children's Hospital, St. Louis, MO, USA.

Journal of Neonatal-Perinatal Medicine
|May 31, 2018
PubMed

Insights

Maternal A1c levels above 6.8% predict increased glucose infusion rate (GIR) needs in infants of diabetic mothers (IDMs). Higher A1c also correlates with newborn complications like macrosomia.

Area of Science:

  • Neonatalogy
  • Maternal-Fetal Medicine
  • Endocrinology

Background:

  • Poor maternal glycemic control can lead to fetal hyperinsulinemia and neonatal hyperglycemia.
  • Infants of diabetic mothers (IDMs) may require increased glucose infusion rates (GIR).

Purpose of the Study:

  • To correlate maternal A1c levels with GIR requirements in IDMs.
  • To establish a maternal A1c threshold predictive of GIR needs.
  • To identify associations between maternal A1c and IDM complications.

Main Methods:

  • Retrospective review of paired maternal A1c values and IDM GIR requirements.
  • Logistic regression analysis to compare A1c and GIR.
  • Likelihood ratio calculation to determine A1c threshold.

Main Results:

  • Increasing maternal A1c values significantly correlated with GIR ≥ 5 mg/kg/min (OR, 1.37; p = 0.021).
  • Macrosomia was the most frequent complication (OR, 1.31; p = 0.022).
  • A maternal A1c threshold of 6.8% predicted increased GIR requirements.

Conclusions:

  • Elevated maternal A1c is significantly associated with increased GIR requirements in IDMs.
  • Higher maternal A1c levels correlate with newborn complications, particularly macrosomia.
  • A maternal A1c of 6.8% serves as a predictive threshold for increased neonatal glucose needs.
Abstract

Keywords:
Diabetes mellitusdiabetes complicationsglucose infusion ratehyperinsulinemiainfant of diabetic motherneonatal hypoglycemia

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