2421-PUB: Effect of Incidental Postprandial Hypoglycemia on OGTT in Pregnancy on Maternal and Foetal Outcomes

Aim: The implications of incidental hypoglycaemia during 75g oral glucose tolerance test in pregnant women affects the maternal and fetal outcomes is unclear.

Materials and Methods: We conducted a retrospective analysis of the 1663 women who underwent 75g 2 hour OGTT at 24-28 weeks of gestation between January 2015 to December 2017. Post-prandial hypoglycaemia was defined as blood sugar levels less than 4mmol/L. Sub-optimal birth weight was defined as birth weight less than 3000g. Parametric and non-parametric tests were used to compare baseline characteristics of those with and without post-prandial hypoglycaemia. Linear regression analysis was used to identify independent predictors of birth weight.

Results: Of the 1663 patients, 178 (10.7%) had GDM. In patients without GDM 126 (8%) had post-prandial hypoglycaemia. There were no significant differences in baseline anthropometric and clinical characteristics of those with and without post-prandial hypoglycaemia. After adjustments for age (p=0.003), gestational age at delivery (p<0.0001), ethnicity (p-value<00001), fasting glucose (p<0.0001), and smoking (p-value<0.0001), post-prandial hypoglycaemia was associated with lower birth weight (beta=-106.5, p value=0.01). After adjustment for the above covariates post-prandial hypoglycaemia was significantly associated with suboptimal-birth weight (OR=1.99(CI 1.5-2.4)p-value=0.005). There were no significant differences in APGAR score at 1 and 5 minute (9.63 vs. 9.70 p-value=0.28 at 5 minutes), mode of delivery, bleeding complications during delivery (p=0.8) and neonatal admission to critical care (p=0.8) in those with post-prandial hypoglycaemia as compared to those without it.

Conclusion: Incidental post-prandial hypoglycaemia during the OGTT is associated with suboptimal birth weight and these pregnant women need close follow-up to monitor fetal growth.