Ảnh hưởng đến đường máu ở thai phụ đái tháo đường thai kỳ của liệu pháp corticoid làm tăng trưởng thành phổi thai nhi

Gestational Diabetes Mellitus (GDM) is an escalating public health concern, posing significant risks to both maternal and fetal health. A notable complication is fetal lung immaturity, particularly in preterm births, which remains a leading cause of neonatal mortality and morbidity. To mitigate these risks, antenatal corticosteroids (ACS) are widely recommended to accelerate fetal lung maturation in pregnancies at risk of preterm delivery. However, the administration of ACS in women with GDM presents a unique clinical challenge, as these agents can profoundly impact maternal glycemic control, potentially leading to hyperglycemia and other adverse outcomes. Understanding the dynamics of blood glucose fluctuations post-ACS in this vulnerable population is crucial for optimizing clinical management and ensuring the safety of both mother and fetus. This study aims to describe the changes in blood glucose levels in pregnant women with gestational diabetes mellitus following antenatal corticosteroids administration and to identify associated factors.

Obstetricians, endocrinologists, general practitioners managing pregnant women, and healthcare researchers focused on gestational diabetes and maternal-fetal medicine.

This prospective cross-sectional descriptive study investigated the effect of antenatal corticosteroids (ACS) on maternal glycemic control in 65 pregnant women with gestational diabetes mellitus (GDM) undergoing treatment for fetal lung maturation at Hanoi Obstetrics and Gynecology Hospital between September 2024 and July 2025. The research meticulously collected clinical and laboratory data, including capillary blood glucose variations, over seven days post-ACS administration. The findings revealed a significant increase in blood glucose levels, with a high proportion of women failing to achieve target glycemic control, particularly within the first 72 hours. Specifically, fasting blood glucose levels exceeded 5.3 mmol/L in over 80% of women on days 2-3, persisting at 43% by day 7. Similarly, 2-hour postprandial glucose levels surpassed 6.7 mmol/L in 77.4-82.2% during the initial three days, remaining above 45% until day 7. Notably, no cases of hypoglycemia were observed. The study also established a significant linear correlation between admission HbA1c levels and both fasting and postprandial mean blood glucose, indicating that higher baseline HbA1c values were associated with a greater risk of post-ACS hyperglycemia. These results underscore the profound and sustained impact of antenatal corticosteroids on glycemic regulation in women with gestational diabetes mellitus. The implications are critical for clinical practice, emphasizing the necessity of stringent blood glucose monitoring and comprehensive HbA1c assessment prior to and following ACS administration. Timely and appropriate therapeutic adjustments, including insulin dosage modifications, are paramount to minimize hyperglycemia-related complications and safeguard both maternal and fetal well-being in this high-risk group.