Effect of Antenatal Dexamethasone on Glycemic Response in Women with and Without Gestational Diabetes Mellitus (GDM)

Abstract

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Background and objectives: The gestational diabetes mellitus (GDM) is any degree of glucose intolerance with onset or first recognition during pregnancy. Corticosteroids have a well-known effect on blood sugar levels of both the mother and the newborn. This study aimed to understand the pattern of glycemic response to dexamethasone in pregnant women with and without GDM and the rate of neonatal hypoglycemia and the relationship between maternal hyperglycemia and neonatal hypoglycemia. Methods: Single center, Observational, prospective, open label, double arm, non-randomized cohort study conducted at MGM Medical College and Hospital, Chhatrapati Sambhaji Nagar (Aurangabad), Maharashtra, India. Dexamethasone administration, maternal and neonatal glycemic data, demographic data were retrieved from patient records. Maternal population was divided into 2 cohorts: group A (n=70) comprised pregnant women with GDM and group B (n=70) without GDM; both received Inj. Dexamethasone. Neonatal population comprised newborns born to women included in both cohorts. Results: Median peak blood glucose concentration occurred approximately 7- 8 hours after the administration of first dose of injectable dexamethasone. From group A (GDM), significant hyperglycemia (120-139mg/dL) and severe hyperglycemia (140-159 mg/dL) occurred in 25.7% and 74.3% participants respectively. In group B (non-GDM), the numbers were 65.7% and 8.5% respectively for the same. Babies born to women with severe hyperglycemia were more prone to develop hypoglycemia. Conclusion: antenatal administration of dexamethasone resulted in hyperglycemia in both GDM and non-GDM cases. But the severity of hyperglycemia is significantly higher in women with GDM. Maternal hyperglycemia prior to birth is associated with increased risk of neonatal hypoglycemia.

Keywords: antenatal corticosteroids, Gestational Diabetes Mellitus, hyperglycemia