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Hypoglycemia in pregnancy: maternal characteristics and neonatal outcomes from oral glucose tolerance tests

BMC Pregnancy Childbirth. 2025 Nov 3;25(1):1156. doi: 10.1186/s12884-025-08088-9.

ABSTRACT

OBJECTIVE: Heterogenous results were reported in the effects of hypoglycemia in pregnancy. This study evaluated pregnancy outcomes in women with hypoglycemia during the antenatal 75-gram oral glucose tolerance test (OGTT).

METHODS: OGTT results of the mothers of all live-born delivered in a tertiary obstetrics centre were evaluated between Jan 2021 and June 2022. All patients had OGTT at 26-30th weeks of gestation. Hypoglycemia was defined as any low plasma glucose ≤ 3.5mmol/L on OGTT. Maternal and neonatal outcomes were compared among the four groups; normal results (group 1), hypoglycemia in OGTT (group 2), gestational diabetes mellitus (GDM) (group 3) and pregestational diabetes mellitus (DM) (group 4).

RESULTS: There were 3715 women delivered within the study period and 3164 (85.2%) had normal results. 65 (1.7%) women had hypoglycemia, 464 (12.5%) women had GDM and 22 (0.6%) women had pregestational DM. None of the Group 2 patients were symptomatic. Maternal demographics were comparable. Patients with hypoglycemia during OGTT were not at an increased risk of preterm delivery (1.5% vs. 2.8%, p = 0.86). There was no statistical difference in the incidence of Caesarean Sect. (32.3% vs. 34.4%, p = 0.54), postpartum haemorrhage (10.8% vs. 14.7% p = 0.28). Women with hypoglycemia during OGTT were not at risk of adverse outcome in terms of neonatal intensive care unit admission (16.9% vs. 8.5%, p = 0.28) and Apgar score at 5th minute of life (9.8 vs. 9.8, p = 0.17).

CONCLUSION: Hypoglycemia in antenatal OGTT is not associated with adverse neonatal or maternal outcomes. It is likely to resolve after delivery.

PMID:41184800 | DOI:10.1186/s12884-025-08088-9

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