Early term cesarean section more dangerous with corticosteroid treatment of mothers with diabetes
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Children born via early term scheduled cesarean section to women with any type of diabetes may be at greater risk for neonatal hypoglycemia if their mother is treated with corticosteroids, according to findings published in Diabetes Care.
“Do not administer antenatal steroids for lung maturation to women at and beyond 37 weeks gestation if they have any form of diabetes,” David Simmons, MD, FRCP, FRACP, professor of medicine at Western Sydney University and head of the endocrinology department at Campbelltown Hospital in New South Wales, Australia, told Healio. “If hospitals/services are using steroids in this way, then they should stop until evidence comes along for the practice. This will be a major change in practice and should reduce workload all round and help protect babies in the short and long term.”
Using medical records at Campbelltown Hospital, Simmons and colleagues assessed the occurrence of neonatal hypoglycemia, respiratory distress syndrome and transient tachypnea of the newborn that required neonatal ICU care among children born to women with diabetes who were treated (n = 33; mean age, 33.1 years) or not treated (n = 69; mean age, 32.9 years) with corticosteroids. All mothers gave birth via early term scheduled cesarean section.
The researchers found that 24.2% of the children born to mothers treated with corticosteroids experienced neonatal hypoglycemia compared with 4.4% of those born to mothers not treated with corticosteroids (P = .003). In addition, the adjusted odds of neonatal hypoglycemia were greater for the children born to mothers treated with corticosteroids vs. those born to mothers not treated with corticosteroids (adjusted OR = 18.96; 95% CI, 2.18-165.23).
Differences in respiratory distress syndrome and/or transient tachypnea of the newborn were not statistically significant between the two groups.
“Practice should change if services are giving steroids at this time unless a proper randomized control trial comes along to show otherwise,” the researchers wrote. “This should reduce admissions to neonatal ICU. The reasons for the difference between those with and without diabetes in benefits for respiratory distress syndrome need to be better researched.” – by Phil Neuffer
For more information:
David Simmons, MD, FRCP, FRACP, can be reached at da.simmons@westernsydney.edu.au.
Disclosures: The authors report no relevant financial disclosures.
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