Takeaway
- Delivery of pregnancies with preexisting diabetes mellitus (PDM) <39 weeks may increase risks for neonatal jaundice, neonatal ICU (NICU) admission, and hypoglycemia.
Why this matters
- The rates of PDM are rising.
- Induction of labor (IOL) at 38-40 weeks has been endorsed as routine management.
Key results
- The risk for cesarean delivery (CD) was similar between groups in both nulliparous and multiparous pregnancies.
- Neonates in the IOL group had higher rates (adjusted relative risks; 95% CIs) of:
- NICU admission: 1.50 (1.26-1.77);
- Jaundice: 1.76 (1.32-2.33); and
- Hypoglycemia: 1.61 (1.35-1.93).
- Hypertensive disorders were more common in the expectantly managed group (results not shown).
Study design
- Retrospective population-based cohort study.
- Cohort from the Better Outcomes Registry and Network in Ontario, Canada.
- Included singleton pregnancies with PDM at ≥38 weeks 0 days, 2012-2017.
- Maternal and perinatal outcomes compared in women who underwent IOL at 38 weeks 0 days to 38 weeks 6 days (n=937) and those who were expectantly managed and delivered at ≥39 weeks 0 days (n=1276).
- Primary outcome: relative CD rate.
- Funding: Canadian Institute of Health Research; University of Toronto; others.
Limitations
- Selection bias for IOL group possible.
References
References
