PATTERN OF GLYCEMIC STATUS AFTER STEROID ADMINISTRATION FOR FETAL LUNG
MATURITY IN NORMOGLYCEMIC PREGNANT WOMEN ; A CLINICAL ANALYSIS
Abstract
Objectives To study the patterns of glycemic status in response to
steroid administered to women with risk of preterm delivery between 24
weeks and 36 weeks 6 days of gestation in normoglycemic subjects and to
evaluate if maternal characteristics predicted the development of
hyperglycemia and if Insulin was necessary in the glycemic management
Design : longitudinal study Participants : 76 antenatal women,
normoglycemic status between 24 weeks and 36 week 6 days of gestation
Methods : Antenatal women who screened negative for Gestational Diabetes
Mellitus by 75 gm GTT who received Injection Betamethasone for risk of
preterm delivery . Fasting and Postprandial blood sugar levels were
recorded from day 1 to 7 after steroid administration. Results Forty
seven out of seventy six patients had hyperglycemia of varying severity.
Among the risk factors associated with hyperglycemia,
age>25 years, family history ofdiabetes and hypertension
and BMI >25 have statistically significant association with
hyperglycemia. Insulin was started in a total of 40 patients of 47
hyperglycemic patients (85.1%). Mean Insulin dosage required for day 1
was9.66 units. Among the 40 patients started on Insulin 15 (37.5 %) had
to be continued on Insulin on Day 7 after steroid administration.
Conclusion Significant hyperglycemia can occur in normoglycemic women
also leading to serious maternal- fetal consequences . Testing of all
antenatal patients especially in age group more than 25years, BMI over
25, hypertensive patients, family history of diabetes who are at risk
for development of hyperglycemia ie recommended and start insulin
accordingly thus preventing complications.