Abstract
Objective: To assess if the rates of Caesarean section (CS) and neonatal intensive care unit (NICU) admission differ between gestational diabetes mellitus (GDM) mothers managed with insulin or lifestyle vs. a population without diabetes. The secondary objective was to identify contributory maternal and neonatal factors. Methods: The Alberta Perinatal Health Program database was linked with our Diabetes in Pregnancy database. A total of 359 GDM insulin-treated, 505 GDM lifestyle-managed and 18 520 singleton births of mothers without diabetes were evaluated. Results: The rates of CS in GDM managed with insulin (42%) and lifestyle (34%) were elevated compared to mothers without diabetes (25% p≤0.001). The odds ratio (OR) for CS remained significant for insulintreated GDM (OR 1.94; 95% confidence interval [CI] 1.54, 2.44) and lifestyle-managed GDM (OR 1.41; 95% CI 1.22, 1.64) after multivariable logistic regression modelling. There was no difference in rate of macrosomia. There was a significant difference in NICU admissions for infants born to insulin-treated GDM (21%) vs. nondiabetes (12%, p≤0.001). The difference remained significant after multivariable logistic regression modelling. (OR GDM lifestyle 1.80, 95% CI 1.53, 2.10 and GDM insulin 2.26, 95% CI 2.00, 2.55). Conclusions: A label of GDM, especially, on insulin, increases the odds for CS and NICU admission independent of usual indications for these interventions.
Original language | English (US) |
---|---|
Pages (from-to) | 58-63 |
Number of pages | 6 |
Journal | Canadian Journal of Diabetes |
Volume | 36 |
Issue number | 2 |
DOIs | |
State | Published - 2012 |
Externally published | Yes |
Keywords
- Caesarean section
- Gestational diabetes
- Insulin
- Neonatal intensive care
ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism
- Endocrinology