Neonatal Hypoglycemia after Antenatal Late Preterm Steroids

Area of Science:

• Neonatal Medicine
• Obstetrics
• Pharmacology

Background:

• Late preterm infants face higher morbidity risks compared to term infants.
• Betamethasone (BMZ) reduces respiratory distress but can cause neonatal hypoglycemia.
• Antenatal late preterm steroids (ALPS) are used to mitigate risks in late preterm infants.

Purpose of the Study:

• To identify clinical risk factors for neonatal hypoglycemia following ALPS administration.
• To assess outcomes associated with partial ALPS courses.
• To inform clinical decision-making regarding ALPS use and neonatal care.

Main Methods:

• Retrospective study of 239 pregnant patients delivering between 34-36 weeks gestation.
• Inclusion criteria: received 1-2 doses of ALPS; exclusion criteria: prior BMZ, pregestational diabetes, fetal anomalies, multifetal gestation.
• Neonatal hypoglycemia defined as <30 mg/dL (first 24h) and <45 mg/dL (after 24h).

Main Results:

• Hypoglycemia incidence increased with maternal age, cesarean delivery, and labor onset delivery.
• Deliveries <48 hours post-BMZ were linked to higher hypoglycemia and NICU admission rates.
• Highest hypoglycemia risk observed 12-35 hours after first BMZ dose.

Conclusions:

• Partial ALPS courses were associated with increased neonatal hypoglycemia and NICU admissions.
• Delivery timing relative to BMZ administration is a critical factor for neonatal outcomes.
• Understanding these risks aids in optimizing ALPS use and postnatal care for late preterm infants.