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Poster Session 1

Category: Diabetes

Poster Session 1

(356) Risk factors associated with small for gestational age: a secondary analysis of PRECISE

Wednesday, February 11, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Sarah Nazeer, MD

Cleveland Clinic Lerner College of Medicine
Cleveland Clinic Lerner College of Medicine, Ohio, United States

Coauthor(s)

RB

Rafael Bravo, PhD

Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
CP

Claudia Pedroza, PhD

Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Sean C. Blackwell, MBA, MD

Professor
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Baha M. Sibai, MD

Professor
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
MF

Michal Fishel Bartal, MD

Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States

Objective:
Hypoglycemia has been linked to small for gestational age (SGA) infants; however, there is a paucity of data examining CGM metrics and SGA patterns. This study aimed to evaluate CGM metrics and maternal risk factors associated with SGA.

Study Design:
This was a secondary analysis of the PRECISE trial, in which individuals with singleton pregnancies at 24–30 weeks’ gestation were randomized to either 7-day CGM or standard 2-step screening for GDM. A blinded CGM was placed in the CGM group (NCT05430204). This analysis included participants without GDM and compared those with SGA versus appropriate for gestational age (AGA) infants. The primary outcome was a composite of adverse neonatal outcomes including large for gestational age, shoulder dystocia, birth injury, IV/PO glucose need, respiratory distress, and fetal/neonatal death. Secondary maternal and neonatal outcomes were also assessed. CGM metrics included percentage of time in range (TIR; 60–140 mg/dL), time below range (TBR; ≤63 mg/dL), time above range (TAR; >140 mg/dL), mean glucose, and coefficient of variation. Pearson’s Chi-squared or Fisher’s exact test was used with p< 0.05 as significant.

Results:
Of the 814 participants, 628 (77%) met inclusion— 74 (12%) were SGA and 554 (88%) were AGA. Aside from lower obesity rates in the SGA group (43% vs 59%, p< 0.01), baseline characteristics were similar. No differences were observed in CGM metrics: mean glucose was 103 mg/dL vs 104 mg/dL, and TIR was 92% (±10) vs 91% (±9) in SGA and AGA, respectively (Table 1). Composite neonatal outcomes did not differ (29% vs 24%, p=0.29). SGA infants had higher rates of formula feeding (32% vs 16%, p< 0.01) and induction of labor (64% vs 50%, p< 0.01), with no difference in gestational age at delivery (both 38.0 weeks) (Table 2).

Conclusion:
These findings align with prior studies and suggest CGM metrics may not differ in SGA pregnancies. Further research is needed to define glycemic contributions to fetal growth.