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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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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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