Title:Neonatal and Maternal Outcomes of Insulin Detemir versus Neutral Protamine
Hagedorn for Diabetes Mellitus in Pregnancy
Volume: 19
Issue: 3
Author(s): Seif Bugazia, Mohamed Boshnaf, Mohammad Elbahnasawy, Mostafa Shehata, Fadel Alqatati, Khaled Mohamed Ragab, Ahmed Bostamy Elsnhory, Sarah Makram Elsayed, Mustafa Ali Fathy and Anas Zakarya Nourelden*
Affiliation:
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- International Medical Research Association (IMedRA), Cairo, Egypt
Keywords:
Insulin detemir, neutral protamine Hagedorn, diabetes, pregnancy, systematic review, meta-analysis.
Abstract:
Background and Objective: Diabetes in pregnancy can lead to severe neonatal and maternal
adverse events. Moreover, there is an increase in GDM prevalence. Therefore, we aimed to
compare insulin detemir (IDet) with the neutral protamine Hagedorn (NPH) in diabetic pregnant
women.
Methods: We searched four electronic databases until August 2021: PubMed, Scopus, Web of Science,
and Cochrane. We included randomized controlled studies that compared IDet with NPH in
diabetic pregnant women. We extracted both maternal and neonatal outcomes, and used RevMan
software to conduct the analysis.
Results: Five studies were included. The analysis showed a significantly lower risk of hypoglycemic
events during pregnancy in the IDet group than the NPH group [RR = 0.6, 95% CI [0.43, 0.84],
p = 0.003], and a higher gestational age (GA) at delivery in the IDet group than the NPH group
[MD = 0.28, 95% [0.02, 0.55], p = 0.03]. On the other hand, the analysis revealed non-significant
differences between IDet and NPH in terms of birth weight, congenital anomalies, neonatal hypoglycemia,
preterm delivery, and others.
Conclusion: Insulin detemir (IDet) was preferred over neutral protamine Hagedorn (NPH) in terms
of showing lower rates of hypoglycemic events during pregnancy and a higher gestational age at
delivery. Meanwhile, there were non-significant variations between them with respect to neonatal
outcomes, such as weight at birth, congenital anomalies, or neonatal hypoglycemia.