Abstract

Background: Although rapid infusion of glucose during Cesarean section is associated with maternal and fetal hyperglycemia and subsequent neonatal reflex hypoglycemia, the optimal amount of glucose to administer is controversial. Therefore, we investigated whether intrapartum maternal low-dose 15 g glucose infusion during Cesarean section prevent neonatal hypoglycemia.

Methods: In this prospective controlled study, 60 patients were randomly assigned to two groups: 0% glucose (Group A) and 1% glucose (Group B). Each group received 1500 ml of the allocated solution before delivery. The primary outcome was the neonates’ glucose concentrations 1 hour after birth and the secondary outcomes the neonates’ glucose concentrations at 2 hours and their progress.

Results: After applying inclusion, 14 eligible patients were investigated. Umbilical venous and arterial blood glucose concentrations were significantly higher in Group B than in Group A (64.0 vs. 122.0 mg/dl and 64.0 vs. 118.5 mg/dl); however, there were no significant differences in the neonates’ glucose concentrations 1 and 2 hours after birth between Groups A and B (48.0 vs. 51.0 mg/dl, P=0.516; 56.0 vs. 51.0 mg/dl, P= 0.573, respectively), and only one neonate (10%) in Group A but six (50%) in Group B developed transient tachypnea of the newborn requiring transfer to the NICU. The study was stopped after interim analysis.

Conclusions: Our study demonstrates that intrapartum maternal low-dose 15 g glucose infusion during Cesarean section does not prevent neonatal hypoglycemia more effectively than no maternal glucose infusion. Additionally, even such a small amount of glucose may be hazardous.

Keywords: Cesarean section, neonate, hypoglycemia, glucose, administration