Poster Session 4
Category: Diabetes
Poster Session 4
Maayan Ormianer, MD
Fellow
Hadassah Medical Center and Hebrew University of Jerusalem, Jerusalem, Israel
Jerusalem, Yerushalayim, Israel
Sharon Alpern, MD
Hadassah Medical Center, Ein Kerem Campus, Jerusalem, Israel
Jerusalem, Yerushalayim, Israel
Hadar Rosen, MD
Head, Maternal Fetal Medicine
Hadassah Medical Center and Hebrew University of Jerusalem, Jerusalem, Israel
Hadassah Medical Center Ein Kerem Campus, Jerusalem, Israel, Yerushalayim, Israel
Doron Kabiri, MD, MPH (he/him/his)
Hadassah Medical Center and Hebrew University of Jerusalem, Jerusalem, Israel
Hadassah Medical Center and Hebrew University of Jerusalem, Jerusalem, Israel., Yerushalayim, Israel
Genyah Aharon-Hananel, MD
Hadassah Medical Center and Hebrew University of Jerusalem, Jerusalem, Israel
Jerusalem, Yerushalayim, Israel
Lauren H. Yaeger, MA
Washington University School of Medicine
Washington, Pennsylvania, United States
Joshua Isaac Rosenbloom, MD
Hadassah Medical Center and Hebrew University of Jerusalem, Jerusalem, Israel
Jerusalem, Yerushalayim, Israel
Although high values on glucose screening tests are diagnostic of gestational diabetes, there is controversy in the literature as to the meaning of low values on the tests. Therefore, we performed a systematic review and meta-analysis to investigate whether post glucose test hypoglycemia is related to maternal and neonatal adverse outcomes.
Study Design:
A comprehensive search was performed by a medical librarian for literature in any language through March 2025 that reported perinatal outcomes in pregnant patients with low values on gestational diabetes screening or diagnostic tests. All retrieved titles and abstracts were independently reviewed by two researchers and data were extracted. Random effects meta-analysis was used where appropriate.
Results:
The search resulted in 2596 unique titles of which 63 were deemed potentially eligible and 20 were ultimately included. Study sample sizes ranged from 200-128,999 participants and most studies were retrospective. There was heterogeneity in the types of tests used (50g, 75, and 100g glucose tests), definitions of hypoglycemia, and definitions of outcomes. However, overall, hypoglycemia on a gestational diabetes test was associated with an increased risk of growth restriction (OR 1.46, 95%CI 1.27, 1.68) and NICU admission (OR 1.21, 95% CI 1.00, 1.47), and a lower risk of macrosomia (OR 0.68, 95% CI 0.55, 0.85). When stratifying by type of glucose screen (50g, 75g, or 100g,) results stayed consistent.
Conclusion:
Hypoglycemia on gestational diabetes screening may be associated with a number of adverse neonatal outcomes. In particular, it is associated with IUGR, suggesting that hypoglycemia may be a marker of placental dysfunction. Clinicians should consider monitoring patients with hypoglycemia on gestational diabetes testing with serial growth scans. However, due to heterogeneity in study design and variable definitions, a large prospective study is needed to further elucidate the significance of this common clinical conundrum.