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Am J Perinatol 2015; 32(02): 143-148
DOI: 10.1055/s-0034-1376387
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Maternal Glucose Response to Betamethasone Administration

Elizabeth S. Langen
1   Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
,
Jessica L. Kuperstock
2   Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
,
Joyce F. Sung
3   Department of Obstetrics and Gynecology, University of Colorado, Aurora, Colorado
,
Mark Taslimi
4   Department of Obstetrics and Gynecology, Stanford University, Stanford, California
,
James Byrne
5   Department of Obstetrics and Gynecology, Santa Clara Valley Medical Center, San Jose, California
,
Yasser Y. El-Sayed
4   Department of Obstetrics and Gynecology, Stanford University, Stanford, California
› Author Affiliations
Further Information

Publication History

01 November 2013

03 April 2014

Publication Date:
10 June 2014 (online)

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Abstract

Objective This study aims to describe the pattern of maternal glucose response to betamethasone administration using a continuous glucose monitoring system.

Study Design A prospective observational trial was conducted among women receiving clinically indicated betamethasone between 24 and 34 weeks gestation. At the time of initial betamethasone administration, a continuous glucose monitoring device was inserted which measured interstitial fluid glucose levels every 5 minutes. Glucose levels were monitored for 7 days, until delivery, or until hospital discharge, whichever came first. We recorded the percentage of time women spent above three glucose thresholds: 110, 144, and 180 mg/dL, respectively.

Results A total of 17 women were enrolled at the time of betamethasone administration and data were available for 15 patients. There were 11 nondiabetic and 4 diabetic women. Both diabetic and nondiabetic women had the highest recorded blood glucose readings between 24 and 48 hours after the first injection of betamethasone. In that period, nondiabetic women spent 73, 40, and 17% of the time with blood glucose levels above the 110, 144, and 180 mg/dL thresholds, respectively.

Conclusion Nondiabetic women receiving betamethasone manifest significant hyperglycemia after betamethasone administration. If delivery is imminent, maternal glucose response to betamethasone may need to be monitored to prevent possible neonatal hypoglycemia.

Keywords

pregnancy - betamethasone - maternal glucose control

Note

Dexcom provided the continuous glucose monitoring devices for this study. In addition, Drs. Sung, Taslimi, and El-Sayed were conducting an investigator initiated, industry-funded prospective trial involving the use of the Dexcom continuous glucose monitoring device in pregnant women. The authors have no other financial relationship with Dexcom. The authors have no other conflicts of interest. This article was presented at: 32nd Annual Meeting of the Society for Maternal-Fetal Medicine, February 6–11, 2012; Dallas, TX.


 

  • References

  • 1 Liggins GC, Howie RN. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics 1972; 50 (4) 515-525
    PubMedSearch in Google Scholar
  • 2 Roberts D, Dalziel S. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev 2006; (3) CD004454
    PubMedSearch in Google Scholar
  • 3 Ramírez-Torres MA, Pérez-Monter SE, Espino y Sosa S, Ibargüengoitia-Ochoa F. Effect of betamethasone in blood glucose levels in pregnant diabetic women at risk of preterm birth [in Spanish]. Ginecol Obstet Mex 2011; 79 (9) 565-571
    PubMedSearch in Google Scholar
  • 4 Foglia LM, Deering SH, Lim E, Landy H. Maternal glucose levels after dexamethasone for fetal lung development in twin vs singleton pregnancies. Am J Obstet Gynecol 2008; 199 (4) e1-e4
    PubMedSearch in Google Scholar
  • 5 Star J, Hogan J, Sosa MEB, Carpenter MW. Glucocorticoid-associated maternal hyperglycemia: a randomized trial of insulin prophylaxis. J Matern Fetal Med 2000; 9 (5) 273-277
    PubMedSearch in Google Scholar
  • 6 Shelton SD, Boggess KA, Smith T, Herbert WN. Effect of betamethasone on maternal glucose. J Matern Fetal Neonatal Med 2002; 12 (3) 191-195
    CrossrefPubMedSearch in Google Scholar
  • 7 Schumacher A, Sidor J, Bühling KJ. Continuous glucose monitoring using the glucose sensor CGMS in metabolically normal pregnant women during betamethasone therapy for fetal respiratory distress syndrome [in German]. Z Geburtshilfe Neonatol 2006; 210 (5) 184-190
    Thieme ConnectPubMedSearch in Google Scholar
  • 8 Refuerzo JS, Garg A, Rech B, Ramin SM, Vidaeff A, Blackwell SC. Continuous glucose monitoring in diabetic women following antenatal corticosteroid therapy: a pilot study. Am J Perinatol 2012; 29 (5) 335-338
    Thieme ConnectPubMedSearch in Google Scholar
  • 9 ACOG Committee on Practice Bulletins. ACOG practice bulletin. Clinical management guidelines for obstetrician-gynecologists. Number 60. March 2005. Pregestational diabetes mellitus. Obstet Gynecol 2005; 105 (3) 675-685
    CrossrefPubMedSearch in Google Scholar
  • 10 Barrett HL, Morris J, McElduff A. Watchful waiting: a management protocol for maternal glycaemia in the peripartum period. Aust N Z J Obstet Gynaecol 2009; 49 (2) 162-167
    CrossrefPubMedSearch in Google Scholar
  • 11 Carron Brown S, Kyne-Grzebalski D, Mwangi B, Taylor R. Effect of management policy upon 120 Type 1 diabetic pregnancies: policy decisions in practice. Diabet Med 1999; 16 (7) 573-578
    CrossrefPubMedSearch in Google Scholar
  • 12 Siegmund T, Rad NT, Ritterath C, Siebert G, Henrich W, Buhling KJ. Longitudinal changes in the continuous glucose profile measured by the CGMS in healthy pregnant women and determination of cut-off values. Eur J Obstet Gynecol Reprod Biol 2008; 139 (1) 46-52
    CrossrefPubMedSearch in Google Scholar