OBJECTIVE To examine the relationship between gestational glucose intolerance (GGI) and neonatal hypoglycemia. RESEARCH DESIGN AND METHODS This was a secondary analysis of 8,262 mother-infant dyads, with delivery at two hospitals between 2014 and 2023. We categorized maternal glycemic status as normal glucose tolerance (NGT), GGI, or gestational diabetes mellitus (GDM). We defined NGT according to a normal glucose load test result, GGI according to an abnormal glucose load test result with zero (GGI-0) or one (GGI-1) abnormal value on the 100-g oral glucose tolerance test, and GDM according to an abnormal glucose load test result with two or more abnormal values on the glucose tolerance test. Neonatal hypoglycemia was defined according to blood glucose <45 mg/dL or ICD-9 or ICD-10 diagnosis of neonatal hypoglycemia. We used logistic regression analysis to determine associations between maternal glucose tolerance category and neonatal hypoglycemia and conducted a sensitivity analysis using Δ-adjusted multiple imputation, assuming for unscreened infants a rate of neonatal hypoglycemia as high as 33%. RESULTS Of infants, 12% had neonatal hypoglycemia. In adjusted models, infants born to mothers with GGI-0 had 1.28 (95% 1.12, 1.65), GGI-1 1.58 (95% CI 1.11, 2.25), and GDM 4.90 (95% CI 3.81, 6.29) times higher odds of neonatal hypoglycemia in comparison with infants born to mothers with NGT. Associations in sensitivity analyses were consistent with the primary analysis. CONCLUSIONS GGI is associated with increased risk of neonatal hypoglycemia. Future research should include examination of these associations in a cohort with more complete neonatal blood glucose ascertainment and determination of the clinical significance of these findings on long-term child health.

中文翻译：

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妊娠期葡萄糖不耐受母亲的婴儿发生新生儿低血糖的风险


目的探讨妊娠期葡萄糖耐受不良（GGI）与新生儿低血糖之间的关系。研究设计和方法 这是对 2014 年至 2023 年间在两家医院分娩的 8,262 名母婴的二次分析。我们将母亲血糖状态分类为正常糖耐量 (NGT)、GGI 或妊娠糖尿病 (GDM)。我们根据正常的葡萄糖负荷测试结果定义NGT，根据100克口服葡萄糖耐量测试中零（GGI-0）或1（GGI-1）异常值的异常葡萄糖负荷测试结果定义GGI，根据GDM葡萄糖负荷试验结果异常，葡萄糖耐量试验有两个或多个异常值。新生儿低血糖的定义是根据血糖<45 mg/dL或ICD-9或ICD-10对新生儿低血糖的诊断。我们使用逻辑回归分析来确定母亲葡萄糖耐量类别与新生儿低血糖之间的关联，并使用 Δ 调整多重插补进行敏感性分析，假设未经筛查的婴儿新生儿低血糖发生率高达 33%。结果 在婴儿中，12% 患有新生儿低血糖。在调整后的模型中，GGI-0 母亲所生婴儿的患病几率是 GGI-0 的 1.28 (95% CI 1.12, 1.65)、GGI-1 1.58 (95% CI 1.11, 2.25) 和 GDM 4.90 (95% CI 3.81, 6.29) 倍。新生儿低血糖与 NGT 母亲所生婴儿的比较。敏感性分析中的关联与主要分析一致。结论 GGI 与新生儿低血糖风险增加相关。未来的研究应包括在更完整的新生儿血糖确定队列中检查这些关联，并确定这些发现对长期儿童健康的临床意义。