Neonatal Hypoglycemia in Diabetic Mothers: a Systematic Review

Hypoglycemia occurs in approximately 8-30% of neonates born to mothers with diabetes. The full extent of the individual and contextual risk factors of hypoglycemia remains unclear and no systematic review of the available studies exists to date. We identified published studies using PubMed and EBSCO host search engines. A modified STROBE statement was used to assess studies\u27 strengths, weaknesses, and generalizability. A total of 16 articles were eligible for full text review. The clinical risk factors in these studies were broadly classified into two: infant-related and mother-related risk factors. The identified infant-related risk factors were SGA, macrosomia, prematurity, lower cord blood glucose, ponderal index and male sex. On the other hand, mother-related risk factors includes maternal hyperglycemia, ethnic origin, diabetes diagnosed prior to 28 weeks of gestation, pre-pregnancy BMI of ≥ 25 kg/m², blood glucose, maternal diabetes type and maternal HbA1c. Irrespective of diabetes type, infants born to diabetic mothers appear to have a higher risk of developing hypoglycemia compare to those born to normal mothers. The overall evidence suggested that these studies mainly focus on the clinical characteristics of infants and mothers. Future research should focus on the identification of risk factors at the individual and contextual levels that can independently predict neonatal hypoglycemia. Appropriate emphasis should also be given to better define neonatal hypoglycemia