Label of gestational diabetes mellitus affects caesarean section and neonatal intensive care unit admission without conventional indications

Lois E. Donovan, Shawna L. Boyle, Deborah A. McNeil, Sue D. Pedersen, Stafford R. Dean, Stephen Wood, Alun L. Edwards

Research output: Contribution to journalArticle

3 Scopus citations

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 languageEnglish (US)
Pages (from-to)58-63
Number of pages6
JournalCanadian Journal of Diabetes
Volume36
Issue number2
DOIs
StatePublished - 2012

Keywords

  • Caesarean section
  • Gestational diabetes
  • Insulin
  • Neonatal intensive care

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Fingerprint Dive into the research topics of 'Label of gestational diabetes mellitus affects caesarean section and neonatal intensive care unit admission without conventional indications'. Together they form a unique fingerprint.

Cite this