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Poster Session 1

(202) Intrapartum Continuous Glucose Monitor Profiles and the Association with Neonatal Hypoglycemia

Thursday, January 30, 2025
10:30 AM – 12:30 PM  

    Submitting Author and Presenting Author(s)

  • Gianna L. Wilkie, MD, MSCI (she/her/hers)

    Assistant Professor of Obstetrics and Gynecology
    University of Massachusetts Chan Medical School
    Worcester, Massachusetts, United States

    • Coauthor(s)

  • NA

    Nillani Anandakugan, BS

    University of Massachusetts Chan School of Medicine
    Worcester, Massachusetts, United States

  • SS

    Shani Snow, BS

    University of Massachusetts Chan School of Medicine
    Worcester, Massachusetts, United States

  • Heidi K. Leftwich, DO

    Associate Professor of Obstetrics and Gynecology
    University of Massachusetts Chan School of Medicine
    Worcester, Massachusetts, United States

Objective: Use of continuous glucose monitors (CGMs) is becoming more common among pregnant patients with pregestational diabetes, but little is known about the optimal intrapartum CGM glycemic profiles in pregnancy. The objective of this study was to characterize intrapartum CGM glycemic profiles and any association with neonatal hypoglycemia.

Study Design: This was a retrospective cohort study among subjects with pregestational diabetes between July 1, 2022 and June 1, 2024 that utilized a CGM intrapartum for glycemic monitoring. Demographics and perinatal outcomes were abstracted from the medical record while glycemic profiles (time in range, above range, and below range) were abstracted from the CGM portal. Glucose range was defined as 70-140 mg/dL. Pearson’s correlation coefficient was used to assess association.


Results:

During the study period, 25 subjects with intrapartum CGM data available were identified. Participants were 31.3 years old (±5.8 years), predominately White (72%), and have type 1 diabetes melitus (68%). The average intrapartum glucose was 136.8 mg/dL (±24.4 mg/dL), with subjects spending a mean 39.2% of time above range, 59.4% of time in range, and 1.7% of time below range. The mean neonatal glucose immediately after birth was 46.3 mg/dL (±15.0 mg/dL) and mean glucose 24 hours after birth was 59.2 mg/dL (±13.2 mg/dL). Approximately 52% of neonates required treatment for hypoglycemia, with 25% of those requiring treatment needing intravenous therapy. There was a moderate negative correlation (r=-0.52) between percentage of time in range and mean neonatal glucose within the first 24 hours after birth and a moderate positive correlation (r=0.55) between percentage of time above range and mean neonatal glucose within the first 24 hours after birth.

Conclusion: Characterizing CGM profiles is the first step to better utilization in labor. Despite small numbers, our study shows a correlation with time above range and increased neonatal glucose. Larger studies with standardized intrapartum treatment strategies are needed to determine the optimal intrapartum CGM glycemic profiles.