Neonatal hypoglycemia after antenatal late preterm steroids in individuals with diabetes

OBJECTIVE: To establish whether administration of antenatal late preterm steroids to pregnant people with diabetes resulted in higher risk of neonatal hypoglycemia. STUDY DESIGN: This is a retrospective cohort study of individuals with pre-gestational or gestational diabetes admitted between 34 0/7-36 6/7 weeks’ gestation before and after introduction of an antenatal late preterm steroids protocol. The primary outcome was any neonatal blood glucose ≤ 60 milligrams/deciliter in the first 24 hours of life. RESULTS: Of 123 mother-neonate pairs, 52.8% (N=65) delivered during the post-protocol period; 75.4% of those (N=49) received late preterm steroids. 59.7% (N=34) of the pre-protocol neonates and 81.5% (N=53) of the post-protocol neonates had hypoglycemia (p = 0.008). After controlling for gestational age at delivery and mode of delivery, neonates in the post-protocol group had increased odds of hypoglycemia (adjusted odds ratio 2.96, 95% confidence interval 1.29-6.82). CONCLUSION: Neonates born to mothers with diabetes who received late preterm corticosteroids experienced greater odds of hypoglycemia.