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CME Credit Offered
CME Credit Offered
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Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
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Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 1

Category: Diabetes

Poster Session 1

(289) Implementation of a Standardized Protocol for Intrapartum Diabetes Management

Wednesday, February 11, 2026
10:30 AM - 12:00 PM  
Objective:
To determine if implementation of a standard protocol for intrapartum diabetes management is associated with improved maternal and neonatal outcomes. 

Study Design:
This retrospective cohort study included patients with diabetes in pregnancy who underwent a trial of labor from 1/1/24-3/31/25. In July 2024, a standardized intrapartum diabetes management protocol was implemented, providing structured guidance for blood glucose monitoring and medical management in patients with pregestational and gestational diabetes, with a target intrapartum glucose of 70-120 mg/dL. Before this, management was individualized. Outcomes were compared before (1/1/24–6/30/24) and after (10/1/24–3/31/25) protocol implementation, excluding a 3-month transition. The primary outcome was neonatal hypoglycemia (<50 mg/dL) in the first 24 hours. Secondary neonatal outcomes included NICU admission and hyperbilirubinemia. Maternal outcomes included intrapartum hyperglycemia and insulin treatment. Bivariable analysis compared demographic and clinical characteristics, and a negative binomial model assessed changes in the primary outcome using an interrupted time series analysis.

Results:
There were no significant differences in neonatal outcomes between the pre-(N=483) and post-implementation (N=518) cohorts: neonatal hypoglycemia (54.2% vs 53.3%, p=0.76), hyperbilirubinemia (7.2% vs 8.9%, p=0.34), NICU admission (17% vs 14.7%, p=0.32) (Table 1). Patient characteristics and delivery outcomes were similar between cohorts.  Rates of pregestational diabetes (21.9% vs 21.6%, p=0.90) and insulin use (53.0% vs 54.8%, p=0.56) were similar, however initial HbA1c was lower post-implementation (5.7 vs 5.4, p< 0.01). After implementation, the number of intrapartum glucose checks per patient increased (IRR 1.17, 95% CI 1.12–1.22, p< 0.01) (Figure 1), as did the maximum intrapartum glucose value (115 vs 130, p< 0.01). 

Conclusion:
Implementation of a standardized intrapartum diabetes protocol led to more frequent glucose monitoring and higher recorded maternal glucose values, without worsening neonatal outcomes.