Impact of antenatal corticosteroid exposure on glycemic control in preterm infants assessed by continuous glucose monitoring: preliminary results from a single center study
- 1Neonatal Intensive Care Unit, Department of Maternal and Neonatal Health, IRCCS Istituto Giannina Gaslini , ,
Abstract
Background: Antenatal corticosteroids (ACS) are routinely administered to women at risk of preterm delivery to improve neonatal respiratory outcomes. However, ACS exposure has been associated with neonatal hypoglycemia, and its impact on overall glycemic control and variability—particularly at earlier gestational ages—remains incompletely defined.
Objectives: To evaluate glycemic control using continuous glucose monitoring (CGM) in preterm infants exposed to ACS and to assess the influence of timing of administration and gestational age on glycemic patterns.
Methods: This prospective single-center cohort study included preterm infants born at <35 weeks of gestation and admitted to a level III neonatal intensive care unit between February 2023 and August 2024. Infants were classified according to ACS exposure as complete course, partial course, or no exposure. CGM was performed during the first 48 hours of life. Hypoglycemic (<45 mg/dL) and hyperglycemic (>180 mg/dL) events, as well as glycemic variability assessed by the mean amplitude of glycemic excursions (MAGE), were analyzed. Subgroup analyses were conducted based on the interval between ACS administration and delivery (≤7 days vs >7 days) and gestational age (<34 vs ≥34 weeks). Statistical significance was adjusted using the Benjamini–Hochberg procedure.
Results: Sixty-four infants were included (41 complete ACS, 15 partial ACS, 8 no ACS). Baseline characteristics were comparable among groups. During the first day of life, hypoglycemic events occurred exclusively in infants exposed to a complete course of ACS (p = 0.005), predominantly in those exposed within seven days prior to delivery. This difference was not observed on the second day. Hyperglycemic events were significantly more frequent in infants born before 34 weeks of gestation (p = 0.005). Glycemic variability, assessed by MAGE, did not differ significantly according to ACS exposure, timing, or gestational age.
Conclusions: Exposure to a complete and recent course of ACS is associated with an increased risk of early neonatal hypoglycemia in preterm infants, particularly within the first 24 hours of life. CGM enables detailed assessment of glycemic instability and may support improved metabolic monitoring in this high-risk population.
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BibTeX
@article{bonato2026impact,
title = {{Impact of antenatal corticosteroid exposure on glycemic control in preterm infants assessed by continuous glucose monitoring: preliminary results from a single center study}},
author = {Irene Bonato and Andrea Calandrino and Samuele Caruggi and Marcella Battaglini and Francesco Vinci and Gaia Cipresso and Carolina Montobbio and Chiara Andreato and Giorgia Brigati and Luca Antonio Ramenghi},
journal = {Frontiers in endocrinology},
year = {2026},
month = oct,
doi = {10.3389/fendo.2026.1847988},
url = {https://europepmc.org/article/PMC/PMC13672208},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of antenatal corticosteroid exposure on glycemic control in preterm infants assessed by continuous glucose monitoring: preliminary results from a single center study
AU - Irene Bonato
AU - Andrea Calandrino
AU - Samuele Caruggi
AU - Marcella Battaglini
AU - Francesco Vinci
AU - Gaia Cipresso
AU - Carolina Montobbio
AU - Chiara Andreato
AU - Giorgia Brigati
AU - Luca Antonio Ramenghi
PY - 2026
DA - 2026/10/02
JO - Frontiers in endocrinology
DO - 10.3389/fendo.2026.1847988
UR - https://europepmc.org/article/PMC/PMC13672208
AB - Background: Antenatal corticosteroids (ACS) are routinely administered to women at risk of preterm delivery to improve neonatal respiratory outcomes. However, ACS exposure has been associated with neonatal hypoglycemia, and its impact on overall glycemic control and variability—particularly at earlier gestational ages—remains incompletely defined. Objectives: To evaluate glycemic control using continuous glucose monitoring (CGM) in preterm infants exposed to ACS and to assess the influence of timing of administration and gestational age on glycemic patterns. Methods: This prospective single-center cohort study included preterm infants born at <35 weeks of gestation and admitted to a level III neonatal intensive care unit between February 2023 and August 2024. Infants were classified according to ACS exposure as complete course, partial course, or no exposure. CGM was performed during the first 48 hours of life. Hypoglycemic (<45 mg/dL) and hyperglycemic (>180 mg/dL) events, as well as glycemic variability assessed by the mean amplitude of glycemic excursions (MAGE), were analyzed. Subgroup analyses were conducted based on the interval between ACS administration and delivery (≤7 days vs >7 days) and gestational age (<34 vs ≥34 weeks). Statistical significance was adjusted using the Benjamini–Hochberg procedure. Results: Sixty-four infants were included (41 complete ACS, 15 partial ACS, 8 no ACS). Baseline characteristics were comparable among groups. During the first day of life, hypoglycemic events occurred exclusively in infants exposed to a complete course of ACS (p = 0.005), predominantly in those exposed within seven days prior to delivery. This difference was not observed on the second day. Hyperglycemic events were significantly more frequent in infants born before 34 weeks of gestation (p = 0.005). Glycemic variability, assessed by MAGE, did not differ significantly according to ACS exposure, timing, or gestational age. Conclusions: Exposure to a complete and recent course of ACS is associated with an increased risk of early neonatal hypoglycemia in preterm infants, particularly within the first 24 hours of life. CGM enables detailed assessment of glycemic instability and may support improved metabolic monitoring in this high-risk population.
SN - 1664-2392
ER -