Healio: Elevated but ‘normal’ HbA1c increases odds for neonatal hypoglycemia

By Regina Schaffer

An elevated HbA1c that is still in the prediabetes range was associated with increased risk for neonatal hypoglycemia, particularly among white infants born prematurely, data show.

“Maternal diabetes, including gestational diabetes, typically diagnosed by an oral glucose tolerance test in the second trimester, is a known risk factor for neonatal hypoglycemia and infants born large for gestational age,” Venkatesh Sampath, MD, MRCPCh, professor of pediatrics, neonatologist, medical director of the neonatal diseases research program at Children’s Mercy Kansas City, told Healio.

“Clinicians have suspected that some infants born to mothers without overt diabetes or gestational diabetes may still have an increased risk for hypoglycemia and tend to be larger at birth. However, this has not been systematically evaluated during pregnancy, especially in the context of long-term glucose control in pregnant women. In this study, we wanted to evaluate if long-term maternal glucose homeostasis in the normal range can impact neonatal outcomes such as birth weight and early hypoglycemia. Furthermore, we wanted to investigate whether these relationships are race dependent.”

“We found that maternal HbA1c levels — even within the range often considered acceptable during pregnancy — influenced the incidence of neonatal hypoglycemia and increased birth weight, especially among infants born to white mothers,” Sampath said.

Sampath said the findings, if confirmed in other studies, could suggest tighter glucose regulation during pregnancy is needed.

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