Hyperglycemia and adverse pregnancy outcome study: Neonatal glycemia

Boyd E. Metzger, Bengt Persson, Lynn P. Lowe, Alan R. Dyer, J. Kennedy Cruickshank, Chaicharn Deerochanawong, Henry L. Halliday, Anselm J. Hennis, Helen Liley, Pak C. Ng, Donald R. Coustan, David R. Hadden, Moshe Hod, Jeremy J.N. Oats, Elisabeth R. Trimble

Research output: Contribution to journalArticlepeer-review

120 Scopus citations


OBJECTIVE: The goal was to describe the temporal pattern of neonatal plasma glucose levels and associations with maternal glucose levels, cord serum C-peptide levels, and neonatal size and adiposity. METHODS: A total of 17 094 mothers and infants were included in the Hyperglycemia and Adverse Pregnancy Outcome Study (15 centers in 9 countries). Mothers underwent a 75-g, 2-hour, oral glucose tolerance test (OGTT) at 24 to 32 weeks of gestation. Cord blood and neonatal blood samples were collected. Biochemical neonatal hypoglycemia was defined as glucose levels of <10th percentile (2.2 mmol/L). Clinically identified hypoglycemia was ascertained through medical record review and associations were assessed. RESULTS: Plasma glucose concentrations were stable during the first 5 hours after birth. Maternal glucose levels were weakly positively associated with biochemical neonatal hypoglycemia (odds ratios: 1.07-1.14 for 1-SD higher OGTT glucose levels). Frequency of neonatal hypoglycemia was higher with higher cord C-peptide levels (odds ratio: 11.6 for highest versus lowest C-peptide category). Larger and/or fatter infants were more likely to have hypoglycemia (P < .001), and infants with hypoglycemia tended to have a higher frequency of cord C-peptide levels of >90th percentile. CONCLUSIONS: Mean neonatal plasma glucose concentrations varied little in the first 5 hours after birth, which suggests normal postnatal adjustment. Biochemical and clinical hypoglycemia were weakly related to maternal OGTT glucose measurements but were strongly associated with elevated cord serum C-peptide levels. Larger and/or fatter infants were more likely to develop hypoglycemia and hyperinsulinemia. These relationships suggest physiologic relationships between maternal glycemia and fetal insulin production.

Original languageEnglish (US)
Pages (from-to)e1545-e1552
Issue number6
StatePublished - Dec 2010


  • Cord C-peptide levels
  • Maternal glucose levels
  • Neonatal hypoglycemia
  • Size at birth

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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