Maternal and neonatal outcomes of women with gestational diabetes and without specific medical conditions: an Australian population-based study comparing induction of labor with expectant management.

Autor: Seimon RV; The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia., Natasha N; The Boden Initiative, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia., Schneuer FJ; The Boden Initiative, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia., Pereira G; School of Public Health, Curtin University, Perth, Western Australia, Australia.; Telethon Kids Institute, Perth, Western Australia, Australia.; Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway., Mackie A; Women and Babies, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.; Discipline of Obstetrics, Gynaecology and Neonatology, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia., Ross GP; Discipline of Obstetrics, Gynaecology and Neonatology, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia.; Discipline of Medicine, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia.; Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia., Sweeting AN; The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.; Discipline of Medicine, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia.; Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia., Seeho SKM; Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.; Women and Babies Research, Kolling Institute, Royal North Shore Hospital, The University of Sydney, Sydney, New South Wales, Australia.; Specialty of Obstetrics, Gynaecology and Neonatology, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia., Hocking SL; The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.; Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Jazyk: angličtina
Zdroj: The Australian & New Zealand journal of obstetrics & gynaecology [Aust N Z J Obstet Gynaecol] 2022 Aug; Vol. 62 (4), pp. 525-535. Date of Electronic Publication: 2022 Mar 28.
DOI: 10.1111/ajo.13505
Abstrakt: Background/aims: To evaluate maternal birth and neonatal outcomes among women with gestational diabetes mellitus (GDM), but without specific medical conditions and eligible for vaginal birth who underwent induction of labour (IOL) at term compared with those who were expectantly managed.
Materials and Methods: Population-based cohort study of women with GDM, but without medical conditions, who had a singleton, cephalic birth at 38-41 completed weeks gestation, in New South Wales, Australia between January 2010 and December 2016. Women who underwent IOL at 38, 39, 40 weeks gestation (38-, 39-, 40-induction groups) were compared with those who were managed expectantly and gave birth at and/or beyond the respective gestational age group (38-, 39-, 40-expectant groups). Multivariable logistic regression analysis was used to assess the association between IOL and adverse maternal birth and neonatal outcomes taking into account potential confounding by maternal age, country of birth, smoking, residential location, residential area of socioeconomic disadvantage and birth year.
Results: Of 676 762 women who gave birth during the study period, 66 606 (10%) had GDM; of these, 34799 met the inclusion criteria. Compared with expectant management, those in 38- (adjusted odds ratio (aOR) 1.11; 95% CI, 1.04-1.18), 39- (aOR 1.21; 95% CI, 1.14-1.28) and 40- (aOR 1.50; 95% CI, 1.40-1.60) induction groups had increased risk of caesarean section. Women in the 38-induction group also had an increased risk of composite neonatal morbidity (aOR 1.10; 95% CI, 1.01-1.21), which was not observed at 39- and 40-induction groups. We found no difference between groups in perinatal death or neonatal intensive care unit admission for births at any gestational age.
Conclusion: In women with GDM but without specific medical conditions and eligible for vaginal birth, IOL at 38, 39, 40 weeks gestation is associated with an increased risk of caesarean section.
(© 2022 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)
Databáze: MEDLINE
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