A multi-site randomized controlled trial: Can treatment of steroid-induced maternal hyperglycemia reduce neonatal hypoglycemia in the late preterm period?

Preterm birth is the most common cause of neonatal morbidity and mortality in the United States. Over 70% of preterm births occur in the late preterm period, between 340 – 366 weeks’ gestation. Following publication of a landmark clinical trial in 2016, women at risk of delivering in the late preterm period now receive antenatal corticosteroid injections to promote fetal lung maturity, a practice which has long been the standard of care for women at risk of delivery prior to 34 weeks. While these corticosteroids improve respiratory outcomes for neonates, these injections have side effects, including increased risk of neonatal hypoglycemia (low blood sugar) following delivery, which can result in complications including seizures, developmental delay and even death. We propose a randomized controlled trial examining whether screening and treating mothers for hyperglycemia following steroid administration will decrease hypoglycemia and its attendant complications in neonates following delivery. A timely answer to this question is important as administering steroids to mothers in the late preterm period has already become the standard of care. Northwestern has sufficient obstetric volume to generate data on this important topic, which can be applied to improve care for mothers and infants both here and around the country.