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Randomized controlled trial of induction at 38 weeks versus 40 weeks gestation on maternal and infant outcomes in women with insulin-controlled gestational diabetes

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Summary

Objective

To compare the impact of induction of labor at 38 weeks of gestation with the induction of labor at 40 weeks of gestation in women with insulin-treated gestational diabetes on maternal and fetal outcome.

Study design

In this study 100 pregnant women with insulin-treated gestational diabetes were randomized to either induction of labor at 38 (group I) or 40 weeks (group II) to evaluate the rate of large for gestational age newborns, neonatal hypoglycemia, success rate of deliveries within 48 h and cesarean section rate after induction in both groups.

Results

The difference of large for gestational age newborns was not significant between the two groups (6.8% vs. 12.8%, p = 0.49), 16 (36.4%) newborns in group I and 8 (17.0%) newborns in group II developed hypoglycemia <35 mg/dl (p = 0.04). The success rate for deliveries within 48 h after induction of labor for groups I and II was 77.3% and 92.3%, respectively (p = 0.25). The cesarean section rate after induction of labor was not significantly different between the two groups (24.1% vs. 18.7%, p = 0.49).

Conclusion

In a cohort of women with insulin-treated gestational diabetes, induction of labor at 38 weeks did not significantly reduce the rate of large for gestational age newborns compared to induction at 40 weeks but seems to increase the rate of neonatal hypoglycemia.

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Funding

This research work was performed in a University hospital, with no special funding.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria

    Katharina Worda MD, Dagmar Bancher-Todesca MD, Peter Husslein MD & Christof Worda MD

  2. Department of Obstetrics and Gynecology, General Hospital of Klagenfurt, St. Veiterstraße 47, 9020, Klagenfurt, Austria

    Heinz Leipold MD

Authors
  1. Katharina Worda MD
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  2. Dagmar Bancher-Todesca MD
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  3. Peter Husslein MD
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  4. Christof Worda MD
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  5. Heinz Leipold MD
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Corresponding author

Correspondence to Heinz Leipold MD.

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Conflict of interest

K. Worda, D. Bancher-Todesca, P. Husslein, C. Worda, and H. Leipold declare that they have no competing interests.

Ethical standards

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

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Worda, K., Bancher-Todesca, D., Husslein, P. et al. Randomized controlled trial of induction at 38 weeks versus 40 weeks gestation on maternal and infant outcomes in women with insulin-controlled gestational diabetes. Wien Klin Wochenschr 129, 618–624 (2017). https://doi.org/10.1007/s00508-017-1172-4

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  • DOI: https://doi.org/10.1007/s00508-017-1172-4

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