What question did this study set out to answer?

To evaluate the relationship between continuous glucose monitoring metrics and neonatal outcomes, as well as postpartum glucose metabolism in women with gestational diabetes.

March 18, 2026Open Access

Relationship between continuous maternal intrapartum and postpartum glucose monitoring metrics and neonatal outcomes and postpartum glucose metabolism in individuals with gestational diabetes

Key Points

To evaluate the relationship between continuous glucose monitoring metrics and neonatal outcomes, as well as postpartum glucose metabolism in women with gestational diabetes.
Evaluated 60 pregnant women with gestational diabetes mellitus during peripartum and postpartum periods.
Participants used a blinded continuous glucose monitor for 10 days before delivery.
Conducted 75-g oral glucose tolerance tests at 6–18 weeks postpartum for all women, with a subset using CGM.
Performed univariate and logistic regression analyses to assess associations between CGM metrics and neonatal outcomes.
35% of participants managed with diet only, 65% required pharmacologic therapy.
Induced vaginal or unplanned C-section deliveries showed a higher incidence of neonatal hypoglycemia compared to repeat C-section deliveries.
No significant correlations between maternal CGM-derived metrics and postnatal adaptation in newborns were observed.
Modest associations noted between postdelivery CGM metrics and postpartum OGTT values, with stronger correlations observed for postoperative CGM metrics.

Abstract

Continuous glucose monitoring (CGM) improves maternal and neonatal outcomes in pregnancies complicated by preconception diabetes. CGM measurements may help optimize intrapartum and postpartum glycemic management in pregnant women with GDM. We investigated the use of blinded CGM-derived metrics during labor, delivery, and postpartum supplementary to normally monitored glucose measures in women with GDM to study neonatal outcomes and postpartum glucose metabolism. This prospective observational study evaluated 60 pregnant women with gestational diabetes mellitus (GDM) during the peripartum and postpartum periods. Of these, 35% were managed with diet alone, while 65% required pharmacologic therapy (insulin, metformin, or both). Participants wore a blinded continuous glucose monitor (Dexcom G6 Pro) for 10 days, beginning 1–3 days before delivery. At 6–18 weeks postpartum, all underwent a 75-g oral glucose tolerance test (OGTT), with a subset (n = 28) also using blinded CGM. Univariate and logistic regression analyses assessed associations between CGM metrics in the 24 h preceding delivery and neonatal hypoglycemia or NICU admission. Infants of women having an induced vaginal or unplanned caesarean delivery (C-section) were significantly more likely than infants delivered by repeat C-section to have neonatal hypoglycemia (p = 0.005). No significant correlations between maternal CGM-derived metrics and postnatal adaptation in the newborn were found and none of the models trained to predict neonatal hypoglycemia or intensive unit (NICU) admission showed satisfactory power. While only modest associations between postdelivery CGM metrics and postpartum OGTT values were observed, there were strong correlations between postpartum CGM metrics and OGTT-derived values. In GDM, intrapartum CGM-based metrics were not associated with adverse neonatal outcomes. Future investigations with a larger cohort are needed to assess intra-and postpartum CGM-metrics in women with GDM and their association with neonatal outcomes and OGTT results. ClinicalTrials.gov, NCT05067075 (initiation 11/1/2021).

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