Safe threshold of capillary blood glucose for predicting ear
There is increasing pressure to get women and babies home rapidly after birth. Babies born to mothers with gestational diabetes mellitus (GDM) currently get 24-h inpatient monitoring.

Researchers investigated whether a low-risk group of babies born to mothers with GDM could be defined for shorter inpatient hypoglycemia monitoring.

Singleton, term babies born to women with GDM and no other risk factors for hypoglycemia, were included. Capillary blood glucose (BG) testing and clinical observations for signs of hypoglycemia during the first 24-h after birth. BG was checked in all babies before the second feed. Subsequent testing occurred if the first result was < 2.0 mmol/L or clinical suspicion developed for hypoglycemia.

Neonatal hypoglycemia, defined as either capillary or venous glucose ≤ 2.0 mmol/L and/or clinical signs of neonatal hypoglycemia requiring oral or intravenous dextrose (lethargy, abnormal feeding behavior, or seizures).

Fifteen of 106 babies developed hypoglycemia within the first 24-h. Maternal and neonatal characteristics were not predictive. All babies with hypoglycemia had an initial capillary BG ≤ 2.6 mmol/L 0.96, 95% Confidence Interval. This result was validated on a further 65 babies, of whom 10 developed hypoglycemia, in the first 24-h of life.

Conclusively, using the 2.6 mmol/L thresholds, extended monitoring as an inpatient could have been avoided for 60% of babies in this study.

BMC Pregnancy and Childbirth