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
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 a...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Journal Article |
| Language: | English |
| Published: |
WILEY
2022
|
| Subjects: | |
| Online Access: | http://purl.org/au-research/grants/nhmrc/1099655 http://hdl.handle.net/20.500.11937/93232 |
| _version_ | 1848765714435932160 |
|---|---|
| author | Seimon, R.V. Natasha, N. Schneuer, F.J. Pereira, Gavin Mackie, A. Ross, G.P. Sweeting, A.N. Seeho, S.K.M. Hocking, S.L. |
| author_facet | Seimon, R.V. Natasha, N. Schneuer, F.J. Pereira, Gavin Mackie, A. Ross, G.P. Sweeting, A.N. Seeho, S.K.M. Hocking, S.L. |
| author_sort | Seimon, R.V. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T11:39:38Z |
| format | Journal Article |
| id | curtin-20.500.11937-93232 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:39:38Z |
| publishDate | 2022 |
| publisher | WILEY |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-932322023-10-09T07:09:16Z 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 Seimon, R.V. Natasha, N. Schneuer, F.J. Pereira, Gavin Mackie, A. Ross, G.P. Sweeting, A.N. Seeho, S.K.M. Hocking, S.L. Science & Technology Life Sciences & Biomedicine Obstetrics & Gynecology gestational diabetes mellitus labour induced labour complications birth term caesarean section TERM DELIVERY birth, term caesarean section gestational diabetes mellitus labour complications labour induced Australia Cesarean Section Cohort Studies Diabetes, Gestational Female Humans Infant, Newborn Labor, Induced Pregnancy Watchful Waiting Humans Diabetes, Gestational Cesarean Section Labor, Induced Cohort Studies Pregnancy Infant, Newborn Australia Female Watchful Waiting 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 Journal Article http://hdl.handle.net/20.500.11937/93232 10.1111/ajo.13505 English http://purl.org/au-research/grants/nhmrc/1099655 http://purl.org/au-research/grants/nhmrc/1173991 http://creativecommons.org/licenses/by-nc-nd/4.0/ WILEY fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Obstetrics & Gynecology gestational diabetes mellitus labour induced labour complications birth term caesarean section TERM DELIVERY birth, term caesarean section gestational diabetes mellitus labour complications labour induced Australia Cesarean Section Cohort Studies Diabetes, Gestational Female Humans Infant, Newborn Labor, Induced Pregnancy Watchful Waiting Humans Diabetes, Gestational Cesarean Section Labor, Induced Cohort Studies Pregnancy Infant, Newborn Australia Female Watchful Waiting Seimon, R.V. Natasha, N. Schneuer, F.J. Pereira, Gavin Mackie, A. Ross, G.P. Sweeting, A.N. Seeho, S.K.M. Hocking, S.L. 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 |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Science & Technology Life Sciences & Biomedicine Obstetrics & Gynecology gestational diabetes mellitus labour induced labour complications birth term caesarean section TERM DELIVERY birth, term caesarean section gestational diabetes mellitus labour complications labour induced Australia Cesarean Section Cohort Studies Diabetes, Gestational Female Humans Infant, Newborn Labor, Induced Pregnancy Watchful Waiting Humans Diabetes, Gestational Cesarean Section Labor, Induced Cohort Studies Pregnancy Infant, Newborn Australia Female Watchful Waiting |
| url | http://purl.org/au-research/grants/nhmrc/1099655 http://purl.org/au-research/grants/nhmrc/1099655 http://hdl.handle.net/20.500.11937/93232 |