Maternal Low Fasting Plasm Glucose in the Second Trimester is Associated with Neonatal Asphyxia

Abstract Background Neonatal asphyxia (NA) is associated with neonatal respiratory distress syndrome, cerebral palsy and neonatal death. Risk factors for NA have been identified as maternal hypertension, premature birth and anemia. While the effect of maternal fasting plasm glucose (FPG) in the second trimester of pregnancy on NA remains unclear. Method Retrospective data from 9661 singleton newborns and mothers were analyzed from January 2016 to July 2018 in Tongzhou district, Beijing. Multivariate logistic regression was used to investigate the risk factors of NA, adjusted for gestational hypertension, triglyceride in the second trimester of pregnancy, fetal distress in utero and preterm birth. Results Of the 9,661 newborns, 26 (2.7‰) were diagnosed with neonatal death (Apgar score 1min = 0) and 52 (5.4‰) with varying degrees of asphyxia (Apgar score 1min = 1 to 6). The asphyxia group showed lower FPG [asphyxia group vs non-asphyxia group, 4.5±0.4 vs 4.8±0.5 mmol/L, P<.01], higher triglyceride level (asphyxia group vs non-asphyxia group, 3.0±1.3 vs 2.5±1.9 mmol/L P<.01) in the second trimester, higher rates of gestational hypertension, fetal distress in utero, preterm birth than the non-asphyxia group (P<.05). Multivariate logistic regression revealed that lower FPG in the second trimester was an independent risk factor of NA [adjusted odds ratio (AOR) 0.26; 95% CI 0.08 to 0.80]. Conclusion Pregnant women with low fasting glucose in the second trimester of pregnancy are at increased risk of birth asphyxia in their offspring.