Mahindra, Muhammad Pradhiki;
Jie, Michelle;
Mapindra, Muhammad Pradhika;
Rehman, Sana;
Vaughan, Owen;
Hillman, Sara;
David, Anna L;
(2025)
Gestational reactive hypoglycaemia and adverse pregnancy outcomes: a systematic review and meta-analysis.
BMC Pregnancy Childbirth
, 25
(1)
, Article 888. 10.1186/s12884-025-08016-x.
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Abstract
BACKGROUND: Reactive hypoglycaemia is a condition where blood glucose drops after a glucose load, and may be associated with adverse pregnancy outcomes. This study aimed to determine the association between gestational reactive hypoglycaemia (GRH) and the risk of adverse pregnancy outcomes including those related to diabetes. METHODS: We performed a systematic review and meta-analysis by searching 4 databases: Medline, Embase, Web of science, and Maternity & infant care database, from inception to 1 December 2023. The outcomes of interest were any reported adverse pregnancy outcomes including large for gestational age (LGA), macrosomia, small for gestational age (SGA), fetal growth restriction (FGR), low birth weight (LBW), caesarean delivery, neonatal intensive care unit (NICU) admission, neonatal hypoglycaemia, polyhydramnios, 5-min APGAR score < 7 and preterm delivery. Risk of bias assessment was performed with Newcastle Ottawa scale. Subgroup analysis was also performed. RESULTS: From 14,746 records, 42 studies were selected for full-text assessment. Thirty studies reporting on 114,148 participants, including 18,878 women with GRH, fulfilled eligibility criteria. Pregnancies with observed GRH had higher risk of SGA (RR = 1.49, 95%CI = 1.33, 1.68), LBW (RR = 1.35, 95%CI = 1.13, 1.60), FGR (RR = 1.21, 95%CI = 1.05, 1.41), and NICU admission (RR = 1.23, 95%CI = 1.02, 1.49) compared to the euglycaemic group. At subgroup analyses, GRH diagnosed at postload glucose < 3 mmol/l was associated with an increased risk of NICU admission (RR = 3.39, 95%CI = 1.56, 7.34); and GRH limited to post glucose tolerance test (GTT) was associated with increased risk of polyhydramnios (RR = 1.93, 95%CI = 1.17, 3.20) and SGA (RR = 1.90, 95%CI = 1.01, 3.58). CONCLUSIONS: GRH is a condition not routinely diagnosed in pregnancy but associated with adverse fetal-neonatal outcomes as SGA, FGR, and NICU admission. At GTT, GRH is associated with the risk of polyhydramnios. More studies are still necessary to determine the threshold value for diagnosis of GRH and explore associations with other outcomes related to glucose dysmetabolism.
| Type: | Article |
|---|---|
| Title: | Gestational reactive hypoglycaemia and adverse pregnancy outcomes: a systematic review and meta-analysis |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/s12884-025-08016-x |
| Publisher version: | https://doi.org/10.1186/s12884-025-08016-x |
| Language: | English |
| Additional information: | This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
| Keywords: | Gestational diabetes mellitus, Gestational reactive hypoglycaemia, Low birth weight, Pregnancy outcomes, Small for gestational age., Humans, Pregnancy, Female, Hypoglycemia, Pregnancy Outcome, Infant, Newborn, Pregnancy Complications, Infant, Small for Gestational Age, Fetal Growth Retardation, Fetal Macrosomia, Cesarean Section, Infant, Low Birth Weight |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Maternal and Fetal Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10213125 |
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