[Does Delivery During Holidays Increase the Risk of Neonatal Hypoglycemia in Women with Gestational Diabetes?]

Throughout the 9-months of pregnancy, a woman with gestational diabetes (GDM) is expected to celebrate holidays, which makes coping with diabetes difficult and alters routine glucose control.

We hypothesized that delivery in the first week following a holiday, might be associated with altered glucose homeostasis, causing more neonatal hypoglycemia.

A retrospective study was conducted in a tertiary center between the years 2007-2023. Eligible patients were women with a term singleton pregnancy, diagnosed with GDM. Women were allocated into two groups based on the date of their delivery in relation to holidays, in the first week following a holiday (group 1) and at times unrelated to holidays (group 2). The primary outcome was the incidence of neonatal hypoglycemia, defined as a glucose level of less than 40 mg/dL (2.2 mmol/L) within 24 hours of birth.

We analyzed 332 cases of GDM and 3,179 GDM control cases. Diet-controlled GDM represented most of our cohort (85%), and the mean blood glucose was tightly kept around 100 mg/dl throughout the labor. Baseline maternal and neonatal demographics were comparable between the groups. The incidence of neonatal hypoglycemia did not differ between the two groups, reaching 3.3% in the study group and 4.9% in the control group (p=0.19). The mean neonatal blood glucose at the nursery was also comparable between the groups, 63 ± 10.1 versus 63.2 ± 10.9 (p=0.95), respectively. GDM patients in group 1 had a higher rate of third- or fourth-degree perineal lacerations than group 2 (1.8% vs. 0.8%, p=0.04).

Our findings reassure us that major holidays, when occurring within a week of delivery, do not adversely impact neonatal outcomes in women with GDM.

Management of gestational diabetes during holiday periods may be challenging; however, delivery close to holidays does not increase the risk of neonatal hypoglycemia. Delivery during holiday periods does not increase the risk of neonatal hypoglycemia in women with gestational diabetes.