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Perinatal outcome following induction of labor in patients with good glycemic controlled gestational diabetes: does timing matter?

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To compare maternal and neonatal outcomes in women with good glycemic controlled gestational diabetes mellitus (GDM) undergoing induction of labor at early and late term.

Methods

A retrospective cohort study of all women with singleton pregnancies and well-controlled GDM undergoing induction of labor for non-GDM indications in the early (37 + 0–38 + 6 gestational weeks) and late term (39 + 0–40 + 6 weeks), in a single university-affiliated medical center (2014–2016). Exclusion criteria included: pre-gestational diabetes, multiple gestations and elective cesarean delivery. Maternal and neonatal outcomes were compared between groups. Composite maternal outcome included: post-partum hemorrhage, blood products transfusion, and cesarean or instrumental delivery. Composite neonatal outcome included: neonatal intensive care unit admission, respiratory distress syndrome, hypoglycemia and jaundice.

Results

Overall, 430 women met inclusion criteria. Amongst them, 193 (44.88%) were induced at early term and 237 (55.11%) were induced at late term. There were higher rates of hypertensive complications of any kind and pre-eclampsia, in women induced at early term (11.04% vs. 4.26%, p = 0.021, and 5.92% vs. 1.60%, p = 0.04, respectively). There were no differences in maternal and neonatal outcomes between groups. Rates of composite maternal outcome and composite neonatal outcome did not differ between groups (OR 0.92, 95% CI 0.59–1.44, p = 0.73 and OR 0.78, 95% CI 0.47–1.3, p = 0.36, respectively).

Conclusion

Women with good glycemic controlled GDM may be safely induced at early term, when other indications exist, without an increased risk for adverse maternal or neonatal outcomes.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors

Contributions

AH: project development, data collection, data analysis, and manuscript writing. AP: data collection and data analysis. GO: project development and manuscript editing. EK: data collection and data analysis. UA: project development and manuscript editing. AW: project development and manuscript editing. EH: project development and manuscript writing. LS: project development, data collection, data analysis and manuscript writing.

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Correspondence to Lina Salman.

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All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Hochberg, A., Pardo, A., Oron, G. et al. Perinatal outcome following induction of labor in patients with good glycemic controlled gestational diabetes: does timing matter?. Arch Gynecol Obstet 300, 299–303 (2019). https://doi.org/10.1007/s00404-019-05183-z

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  • DOI: https://doi.org/10.1007/s00404-019-05183-z

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