Diabetes, metabolic syndrome and obesity : targets and therapy · 2026
An Observational Study of Maternal Hypoglycemia in Pregnancy.
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Bleicher Inna, Einav Sharon, Perlov Gavze Revital, Lev Shalem Liat, Sammour Rami
Аннотация
BACKGROUND: Hypoglycemia in pregnancy is relatively understudied, with conflicting evidence suggesting either outcomes similar to normal oral glucose tolerance test (OGTT) or associations with poor neonatal outcomes. Maternal glucose crosses the placenta, thus maternal hypoglycemia may affect the fetus.
OBJECTIVE: This study aimed to evaluate the association between maternal hypoglycemia and neonatal birth weight, specifically the risk of small-for-gestational-age (SGA) neonates, and to examine maternal metabolic outcomes in comparison to normoglycemic and hyperglycemic individuals.
STUDY DESIGN: This retrospective cohort study included 39,306 primiparous individuals aged 18-50 years. Participants were classified as hypoglycemic (glucose <70 mg/dL) hyperglycemic (≥1 abnormal OGTT value), or normoglycemic. The primary outcome was the rate of SGA (<10th percentile) and large-for-gestational-age (LGA, >90th percentile) neonates. Secondary outcomes included maternal hypertensive disorders, gestational diabetes requiring treatment (GDMA2), and long-term risk of diabetes mellitus (DM).
RESULTS: Among the cohort, 16,062 (40.9%) were hypoglycemic, 8543 (21.7%) were hyperglycemic, and 14,701 (37.4%) were normoglycemic. Compared to normoglycemic individuals, hypoglycemia was associated with an increased likelihood of SGA (OR 1.2, 95% CI 1.1-1.4), particularly in the second and third trimesters. Hyperglycemia was associated with an increased likelihood of LGA (OR 1.2, 95% CI 1.1-1.4). Hypoglycemia was also linked to a higher prevalence of gestational diabetes (GDMA2) and dysglycemia during pregnancy, yet a lower likelihood of developing DM later in life compared to hyperglycemic individuals.
CONCLUSION: Maternal hypoglycemia during pregnancy is associated with an increased risk of SGA neonates and may serve as an early marker of underlying glucose dysregulation. Given these findings, repeated glucose monitoring and closer follow-up for individuals with hypoglycemia may be warranted. Future research should investigate long-term neonatal and maternal metabolic outcomes to refine clinical management strategies for hypoglycemia in pregnancy.
OBJECTIVE: This study aimed to evaluate the association between maternal hypoglycemia and neonatal birth weight, specifically the risk of small-for-gestational-age (SGA) neonates, and to examine maternal metabolic outcomes in comparison to normoglycemic and hyperglycemic individuals.
STUDY DESIGN: This retrospective cohort study included 39,306 primiparous individuals aged 18-50 years. Participants were classified as hypoglycemic (glucose <70 mg/dL) hyperglycemic (≥1 abnormal OGTT value), or normoglycemic. The primary outcome was the rate of SGA (<10th percentile) and large-for-gestational-age (LGA, >90th percentile) neonates. Secondary outcomes included maternal hypertensive disorders, gestational diabetes requiring treatment (GDMA2), and long-term risk of diabetes mellitus (DM).
RESULTS: Among the cohort, 16,062 (40.9%) were hypoglycemic, 8543 (21.7%) were hyperglycemic, and 14,701 (37.4%) were normoglycemic. Compared to normoglycemic individuals, hypoglycemia was associated with an increased likelihood of SGA (OR 1.2, 95% CI 1.1-1.4), particularly in the second and third trimesters. Hyperglycemia was associated with an increased likelihood of LGA (OR 1.2, 95% CI 1.1-1.4). Hypoglycemia was also linked to a higher prevalence of gestational diabetes (GDMA2) and dysglycemia during pregnancy, yet a lower likelihood of developing DM later in life compared to hyperglycemic individuals.
CONCLUSION: Maternal hypoglycemia during pregnancy is associated with an increased risk of SGA neonates and may serve as an early marker of underlying glucose dysregulation. Given these findings, repeated glucose monitoring and closer follow-up for individuals with hypoglycemia may be warranted. Future research should investigate long-term neonatal and maternal metabolic outcomes to refine clinical management strategies for hypoglycemia in pregnancy.