1. Impacts of Tocolytics on Maternal and Neonatal Glucose Levels in Women With Gestational Diabetes Mellitus.
- Author
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Hong S, Seol HJ, Lee J, Hwang HS, Sung JH, Kwon JY, Lee SM, Seong WJ, Choi SR, Kim SC, Kim HS, Lee SJ, Choi SK, Lee KA, Ko HS, and Park HS
- Subjects
- Humans, Female, Pregnancy, Retrospective Studies, Adult, Infant, Newborn, Logistic Models, Hyperglycemia drug therapy, Odds Ratio, Obstetric Labor, Premature drug therapy, Pregnancy Outcome, Republic of Korea, Diabetes, Gestational drug therapy, Tocolytic Agents therapeutic use, Tocolytic Agents adverse effects, Blood Glucose analysis, Nifedipine therapeutic use, Nifedipine adverse effects, Hypoglycemia, Ritodrine therapeutic use, Ritodrine adverse effects, Vasotocin analogs & derivatives, Vasotocin therapeutic use, Vasotocin adverse effects
- Abstract
Background: We investigated the impacts of tocolytic agents on maternal and neonatal blood glucose levels in women with gestational diabetes mellitus (GDM) who used tocolytics for preterm labor., Methods: This multi-center, retrospective cohort study included women with GDM who were admitted for preterm labor from twelve hospitals in South Korea. We excluded women with multiple pregnancies, anomalies, overt DM diagnosed before pregnancy or 23 weeks of gestation, and women who received multiple tocolytics. The patients were divided according to the types of tocolytics; atosiban, ritodrine, and nifedipine group. We collected baseline maternal characteristics, pregnancy outcomes, maternal glucose levels during hospitalization, and neonatal glucose levels. We compared the frequency of maternal hyperglycemia and neonatal hypoglycemia among three groups. A multivariate logistic regression analysis was performed to evaluate the contributing factors to the occurrence of maternal hyperglycemia and neonatal hypoglycemia., Results: A total of 128 women were included: 44 (34.4%), 51 (39.8%), and 33 (25.8%) women received atosiban, ritodrine, and nifedipine, respectively. Mean fasting blood glucose (FBG) (112.3, 109.6, and 89.5 mg/dL, P < 0.001) and 2-hour postprandial glucose (PPG2) levels (145.4, 148.3, and 116.5 mg/dL, P = 0.004) were significantly higher in atosiban and ritodrine group than those in nifedipine group. Even after adjusting for covariates including antenatal steroid use, gestational age at admission, and pre-pregnancy body mass index, there was an increased risk of high maternal mean FBG (≥ 95 mg/dL) and PPG2 (≥ 120 mg/dL) levels in the atosiban and ritodrine group than in nifedipine group. The atosiban and ritodrine groups are also at increased risk of neonatal hypoglycemia (< 47 mg/dL) compared to the nifedipine group with the odds ratio of 4.58 and 4.67, respectively ( P < 0.05)., Conclusion: There is an increased risk of maternal hyperglycemia and neonatal hypoglycemia in women with GDM using atosiban and ritodrine tocolytics for preterm labor compared to those using nifedipine., Competing Interests: Hyun Soo Park and Hyun-Joo Seol participated in the Tractocile (atosiban) Advisory Board and received consulting fees from Ferring Pharmaceuticals Korea on October 24, 2023. Other authors have no potential conflicts of interest., (© 2024 The Korean Academy of Medical Sciences.)
- Published
- 2024
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