Drug-Induced Hypoglycemia in Neonates Born to Nondiabetic Women Treated with Medications during the Pregnancy or the Labor: A Systematic Review of the Literature

Abstract

The prompt identification of at-risk newborns for drug-induced hypoglycemia can minimize the risk for adverse side effects, inappropriate investigations, and considerable unnecessary costs. Existing literature discusses drug-induced hypoglycemia, but a systematic description of neonatal hypoglycemia induced or exacerbated by maternal medications is missing. We reviewed the association between neonatal hypoglycemia and maternal medications. We systematically searched the literature according to the PICOS model on drug-induced hypoglycemia in neonates born to nondiabetic women treated with medications during the pregnancy or the labor. The main outcomes of the review were: (1) prevalence of hypoglycemia, (2) risk factors and potential confounders, (3) time at onset and severity of hypoglycemia, (4) dose–response gradient, (5) metabolic features of hypoglycemia, (6) modalities to treat hypoglycemia, and (7) quality of the studies. We included 69 studies in this review and we identified 11 groups of maternal drugs related to neonatal hypoglycemia. Results were classified for each outcome. Our review aims at supporting clinicians in the identification of the newborn at risk for hypoglycemia and in the differential diagnosis of neonatal hypoglycemia. Further studies are necessary to assess the risk of neonatal hypoglycemia associated with common maternal medications.

Key Points

• A systematic description of neonatal hypoglycemia induced or exacerbated by maternal medications is missing.

• In our review we identified 11 groups of maternal drugs related to neonatal hypoglycemia.

• Our review aims at supporting clinicians in the identification of the newborn at risk for hypoglycemia.

Keywords

hypoglycemia - hyperinsulinism - perinatal - drug-induced hyperinsulinism - review

Ethical Approval

The latest revision of the Helsinki Declaration as well as the Oviedo Declaration were the basis for the ethical conduct of the study. The study protocol was designed and conducted to ensure adherence to the principles and procedures of good clinical practice and to comply with the Italian laws. This research, based on previously published literature, did not meet criteria for local ethics committee approval.

Patient Consent

Written informed consents for publication of the clinical details were obtained from the parents of patient.

Authors' Contributions

E.M. and R.F. conceived, planned, and conceptualized the study. Two independent investigators (E.M. and R.F.) screened identified studies' titles and abstracts. Discrepancies were resolved by consensus or involving a third investigator (M.C.C.). G.P. and A.M. revised the manuscript. All authors approved the final version as submitted.

Publikationsverlauf

Eingereicht: 01. August 2023

Angenommen: 08. September 2023

Artikel online veröffentlicht:
17. Oktober 2023

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