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Poster Session 1

Category: Diabetes

Poster Session 1

(106) Association of Inpatient Surveillance with Perinatal Outcomes in Gestational Diabetes Requiring Insulin

Wednesday, February 11, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Alesha M. White, MD (she/her/hers)

Maternal Fetal Medicine Fellow
University of Texas Southwestern Medical Center
Grand Prairie, Texas, United States

Coauthor(s)

AL

Ashlyn Lafferty, MD

University of Texas Southwestern Medical Center
Dallas, Texas, United States
SG

Sryea Gandra, BS

University of Texas Southwestern Medical Center
Dallas, Texas, United States
SM

So-Van Maxwell, BS

University of Texas Southwestern Medical Center
Dallas, Texas, United States
JP

Jessica E. Pruszynski, PhD

University of Texas Southwestern Medical Center
Dallas, Texas, United States
Elaine L. Duryea, MD

Associate Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Catherine Y. Spong, MD

Professor and Chair
University of Texas Southwestern Medical Center
Dallas, Texas, United States

Objective:
Although data is limited, antenatal testing is recommended for patients with gestational diabetes mellitus (GDM) managed with insulin starting at 32 weeks. The purpose of this study was to explore the relationship between inpatient surveillance with use of antenatal testing and perinatal outcomes in a GDM population.

Study Design:
Retrospective cohort study of patients with GDM requiring insulin who delivered between 2022 and 2024 at a large county hospital. At our institution, outpatient antenatal testing in the form of non-stress tests (NSTs) is not performed. Hospital admission is recommended at 34 weeks for all patients on insulin to enhance glycemic control and fetal monitoring. Patients who decline admission are followed outpatient. Perinatal outcomes for patients who did and did not undergo inpatient surveillance were compared. A neonatal composite outcome including rates of large for gestational age (LGA), hypoglycemia, admission to the neonatal intensive care unit, neonatal death and stillbirth was compared. Patients who were admitted for less than 1 week, who did not receive prenatal care with our institution, or who delivered prior to 34 weeks were excluded.

Results:
530 patients with GDM requiring insulin were included. 155 (29%) were admitted for inpatient surveillance. Despite similar A1c’s, patients who were admitted had improved glycemic control (Table 1). Although gestational age was significantly different, the difference was not clinically relevant. There was no difference in the neonatal composite outcome between the two cohorts. Neonates born to patients who were admitted for inpatient surveillance had lower birthweights (3182g (2920-3536) vs 3308g (2980-3724), p=0.004) and lower rates of LGA (13% vs 22%, p=0.022) (Table 2). Fetal weight remained significant even after adjusting for gestational age (p =0.017).

Conclusion:
Inpatient surveillance was associated with improved glycemic control and reduced rates of LGA infants, however the majority of patients were unable to accept admission. Future studies should focus on increasing accessibility to similar programs.