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Gestational diabetes mellitus and time in active labor: A population‐based cohort study
INTRODUCTION: Women with gestational diabetes mellitus (GDM) have higher rates of adverse perinatal outcomes compared with women without GDM, including an increased risk for having labor induced and for cesarean section. The findings from previous studies analyzing duration of labor in women with GD...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10333652/ https://www.ncbi.nlm.nih.gov/pubmed/37170849 http://dx.doi.org/10.1111/aogs.14592 |
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author | Nevander, Sofia Carlhäll, Sara Källén, Karin Lilliecreutz, Caroline Blomberg, Marie |
author_facet | Nevander, Sofia Carlhäll, Sara Källén, Karin Lilliecreutz, Caroline Blomberg, Marie |
author_sort | Nevander, Sofia |
collection | PubMed |
description | INTRODUCTION: Women with gestational diabetes mellitus (GDM) have higher rates of adverse perinatal outcomes compared with women without GDM, including an increased risk for having labor induced and for cesarean section. The findings from previous studies analyzing duration of labor in women with GDM are contradictory. The aim of the study was to evaluate the impact of GDM on time in spontaneous and induced active labor. MATERIAL AND METHODS: This was a population‐based cohort study including 247 524 primiparous women who gave birth to a singleton fetus with cephalic presentation, ≥34(+0) (completed gestational weeks + additional days) between January 2014 and May 2020 in Sweden. Data was obtained from the Swedish Pregnancy Register. Time in active labor was compared between women with GDM and without GDM with a spontaneous labor onset or induction of labor using Kaplan Meier survival analysis and Cox regression analysis. RESULTS: Women with GDM had significantly longer time in active labor, both with a spontaneous onset and induction of labor compared to women without GDM. Women with GDM had a decreased chance of vaginal delivery at a certain time‐point compared to women without GDM, with adjusted hazard ratio of 0.92 (0.88–0.96) and 0.83 (0.76–0.90) for those with spontaneous onset and induction of labor, respectively. Women with GDM had increased risk for time in active labor ≥12 h both in spontaneous labor onset (adjusted odds ratio 1.14 [1.04–1.25]) and in induction of labor (adjusted odds ratio 1.55 [1.28–1.87]). CONCLUSIONS: Women with GDM seem to spend a longer time in active labor, both in spontaneous and induced active labor compared to women without GDM. To be able to individualize care intrapartum, there is a need for more studies demonstrating the impact of hyperglycemia during pregnancy on outcomes during childbirth. |
format | Online Article Text |
id | pubmed-10333652 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-103336522023-07-12 Gestational diabetes mellitus and time in active labor: A population‐based cohort study Nevander, Sofia Carlhäll, Sara Källén, Karin Lilliecreutz, Caroline Blomberg, Marie Acta Obstet Gynecol Scand Birth INTRODUCTION: Women with gestational diabetes mellitus (GDM) have higher rates of adverse perinatal outcomes compared with women without GDM, including an increased risk for having labor induced and for cesarean section. The findings from previous studies analyzing duration of labor in women with GDM are contradictory. The aim of the study was to evaluate the impact of GDM on time in spontaneous and induced active labor. MATERIAL AND METHODS: This was a population‐based cohort study including 247 524 primiparous women who gave birth to a singleton fetus with cephalic presentation, ≥34(+0) (completed gestational weeks + additional days) between January 2014 and May 2020 in Sweden. Data was obtained from the Swedish Pregnancy Register. Time in active labor was compared between women with GDM and without GDM with a spontaneous labor onset or induction of labor using Kaplan Meier survival analysis and Cox regression analysis. RESULTS: Women with GDM had significantly longer time in active labor, both with a spontaneous onset and induction of labor compared to women without GDM. Women with GDM had a decreased chance of vaginal delivery at a certain time‐point compared to women without GDM, with adjusted hazard ratio of 0.92 (0.88–0.96) and 0.83 (0.76–0.90) for those with spontaneous onset and induction of labor, respectively. Women with GDM had increased risk for time in active labor ≥12 h both in spontaneous labor onset (adjusted odds ratio 1.14 [1.04–1.25]) and in induction of labor (adjusted odds ratio 1.55 [1.28–1.87]). CONCLUSIONS: Women with GDM seem to spend a longer time in active labor, both in spontaneous and induced active labor compared to women without GDM. To be able to individualize care intrapartum, there is a need for more studies demonstrating the impact of hyperglycemia during pregnancy on outcomes during childbirth. John Wiley and Sons Inc. 2023-05-12 /pmc/articles/PMC10333652/ /pubmed/37170849 http://dx.doi.org/10.1111/aogs.14592 Text en © 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Birth Nevander, Sofia Carlhäll, Sara Källén, Karin Lilliecreutz, Caroline Blomberg, Marie Gestational diabetes mellitus and time in active labor: A population‐based cohort study |
title | Gestational diabetes mellitus and time in active labor: A population‐based cohort study |
title_full | Gestational diabetes mellitus and time in active labor: A population‐based cohort study |
title_fullStr | Gestational diabetes mellitus and time in active labor: A population‐based cohort study |
title_full_unstemmed | Gestational diabetes mellitus and time in active labor: A population‐based cohort study |
title_short | Gestational diabetes mellitus and time in active labor: A population‐based cohort study |
title_sort | gestational diabetes mellitus and time in active labor: a population‐based cohort study |
topic | Birth |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10333652/ https://www.ncbi.nlm.nih.gov/pubmed/37170849 http://dx.doi.org/10.1111/aogs.14592 |
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