Hyperglycemia in pregnancy did not worsen the short-term outcomes of very preterm infants: a propensity score matching study

Ying Li; Wei Shen; Rong Zhang; Jian Mao; Ling Liu; Yan-Mei Chang; Xiu-Zhen Ye; Yin-Ping Qiu; Li Ma; Rui Cheng; Hui Wu; Dong-Mei Chen; Ling Chen; Ping Xu; Hua Mei; San-Nan Wang; Fa-Lin Xu; Rong Ju; Xiao-Mei Tong; Xin-Zhu Lin; Fan Wu

doi:10.3389/fped.2024.1341221

Hyperglycemia in pregnancy did not worsen the short-term outcomes of very preterm infants: a propensity score matching study

Front Pediatr. 2024 Mar 6:12:1341221. doi: 10.3389/fped.2024.1341221. eCollection 2024.

Authors

Ying Li^#¹, Wei Shen^#^{2

3}, Rong Zhang⁴, Jian Mao⁵, Ling Liu⁶, Yan-Mei Chang⁷, Xiu-Zhen Ye⁸, Yin-Ping Qiu⁹, Li Ma¹⁰, Rui Cheng¹¹, Hui Wu¹², Dong-Mei Chen¹³, Ling Chen¹⁴, Ping Xu¹⁵, Hua Mei¹⁶, San-Nan Wang¹⁷, Fa-Lin Xu¹⁸, Rong Ju¹⁹, Xiao-Mei Tong⁷, Xin-Zhu Lin^{2

3}, Fan Wu^{1

20}

Affiliations

¹ Department of Neonatology, Guangzhou Key Laboratory of Neonatal Intestinal Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
² Department of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China.
³ Xiamen Key Laboratory of Perinatal-Neonatal Infection, Xiamen, Fujian, China.
⁴ Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
⁵ Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
⁶ Department of Neonatology, Guiyang Maternal and Child Health Hospital·Guiyang Children's Hospital, Guiyang, Guizhou, China.
⁷ Department of Pediatrics, Peking University Third Hospital, Beijing, China.
⁸ Department of Neonatology, Guangdong Province Maternal and Children's Hospital, Guangzhou, Guangdong, China.
⁹ Department of Neonatology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
¹⁰ Department of Neonatology, Children's Hospital of Hebei Province, Shijiazhuang, Hebei, China.
¹¹ Department of Neonatology, Children' Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
¹² Department of Neonatology, The First Hospital of Jilin University, Changchun, Jilin, China.
¹³ Department of Neonatology, Quanzhou Maternity and Children's Hospital, Quanzhou, Fujian, China.
¹⁴ Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
¹⁵ Department of Neonatology, Liaocheng People's Hospital, Liaocheng, Shandong, China.
¹⁶ Department of Neonatology, The Affiliate Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
¹⁷ Department of Neonatology, Suzhou Municipal Hospital, Suzhou, Jiangsu, China.
¹⁸ Department of Neonatology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
¹⁹ Department of Neonatology, Chengdu Women' and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
²⁰ Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.

^# Contributed equally.

Abstract

Background: Hyperglycemia in pregnancy (HGP) has generally been considered a risk factor associated with adverse outcomes in offspring, but its impact on the short-term outcomes of very preterm infants remains unclear.

Methods: A secondary analysis was performed based on clinical data collected prospectively from 28 hospitals in seven regions of China from September 2019 to December 2020. According to maternal HGP, all infants were divided into the HGP group or the non-HGP group. A propensity score matching analysis was used to adjust for confounding factors, including gestational age, twin or multiple births, sex, antenatal steroid administration, delivery mode and hypertensive disorders of pregnancy. The main complications and the short-term growth status during hospitalization were evaluated in the HGP and non-HGP groups.

Results: A total of 2,514 infants were eligible for analysis. After matching, there were 437 infants in the HGP group and 874 infants in the non-HGP group. There was no significant difference between the two groups in main complications including respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity, patent ductus arteriosus, culture positive sepsis, intraventricular hemorrhage, periventricular leukomalacia, anemia, feeding intolerance, metabolic bone disease of prematurity, or parenteral nutrition-associated cholestasis. The incidences of extrauterine growth retardation and increased growth retardation for weight and head circumference in the non-HGP group were all higher than those in the HGP group after matching (P < 0.05).

Conclusions: HGP did not worsen the short-term outcomes of the surviving very preterm infants, as it did not lead to a higher risk of the main neonatal complications, and the infants' growth improved during hospitalization.

Keywords: complication; growth retardation; hyperglycemia in pregnancy; outcomes; preterm infant.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article.