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Recording available 2/16-5/2
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Oral Concurrent Session 2 - Diabetes

Oral Concurrent Sessions

Oral Concurrent Session 2 - Diabetes

(26) Investigating Continuous Glucose Monitoring (CGM) metrics for gestational diabetes to optimize neonatal health

Wednesday, February 11, 2026
2:45 PM - 3:00 PM  
Location: Summit 211 - 214
Abstract Award

    Submitting Author and Presenting Author(s)

  • Amy M. Valent, DO (she/her/hers)

    Associate Professor, Dept. of OBGYN - MFM Division
    Oregon Health & Science University
    Portland, Oregon, United States

    • Coauthor(s)

  • Celeste Durnwald, MD (she/her/hers)

    Professor, OB/GYN, Maternal Fetal Medicine
    Perelman School of Medicine at the University of Pennsylvania
    Philadelphia, Pennsylvania, United States

  • KR

    Katrina Ramsey, MPH

    Oregon Health & Science University
    Portland, Oregon, United States

  • EF

    Emily Fay, MD

    University of Washington
    Seattle, Washington, United States

  • Nicole M. Ehrhardt, MD

    Assistant Professor of Medicine
    University of Washington
    Seattle, Washington, United States

Objective:
Available evidence of CGM metrics shown to improve perinatal and neonatal outcomes are only among pregnancies with type 1 diabetes. Prior GDM studies have not included a sufficient sample size to identify CGM metrics linked to reduced neonatal complications. The objective is to identify CGM metrics (time in range [TIR] and mean glucose) associated with lower rates of adverse neonatal outcomes in individuals with GDM.

Study Design:
Our study analyzed data from three RCTs using Dexcom G6 or G6 Pro CGM devices in individuals with GDM to assess the relationship between CGM metrics and composite adverse neonatal outcomes (NICU admission, transient tachypnea, respiratory distress syndrome, birth injury, or hyperbilirubinemia requiring phototherapy). Participants with < 96 hours of CGM data after 24 weeks' gestation or missing outcome data were excluded. Standard pregnancy percent TIR of 63-140 mg/dl and a lower glycemic TIR 63-120 mg/dL were analyzed.

Results:

Of 223 total participants with GDM among the 3 RCTs, 205 were included in the final analysis. Approximately 16% (n=32) of the participants had a neonate with an adverse outcome. Individuals with a higher percent TIR (63-140mg/dL) had lower neonatal composite outcome, particularly in the lower range 63-120 mg/dL; Figure. For a one-category difference in TIR, there was an 18% reduction in neonatal risk using the standard pregnancy TIR (63-140 mg/dL; RR 0.82 [95% CI 0.69, 0.98]) and a 21% reduction using the lower glycemic range (63-120 mg/dL; RR 0.79 [95% CI 0.64, 0.97]). Adverse neonatal outcomes were associated with higher time above range (TAR) >140mg/dL (median [IQR]: 7 [4-15] vs 4% [2-10]) and TAR >120mg/dL (24 [14-40] vs 16% [10-27]). TIR correlated with the 24-h mean glucose with the lowest risk among those with a 24-h mean glucose < 95 mg/dL.

Conclusion:
Adverse neonatal outcomes are common among pregnancies complicated by GDM. For every categorical improvement in glucose TIR, there is a significant risk reduction in adverse neonatal outcomes. Future prospective studies are needed to validate these findings.