Outcomes of vacuum-assisted vaginal deliveries of mothers with gestational diabetes mellitus.

Objective

To evaluate the outcomes of vacuum-assisted vaginal deliveries (VAD) among neonates of mothers with gestational diabetes mellitus (GDM). Study design: Retrospective cohort study of women with singleton gestation ≥37 + 0 weeks of gestation who underwent VAD at a single, tertiary, medical center (2007-2014). Women with GDM and their neonates were compared to women without diabetes and their neonates. Composite neonatal outcome was defined as ≥1 of the following: shoulder dystocia, 5-min Apgar score <7, asphyxia, seizure, subgaleal, subarachnoid or subdural hemorrhage, fracture of the clavicle, humerus or skull, or Erb's palsy.

Results

Overall, 251 (5.2%) women with GDM were compared with 4534 (94.8%) women without GDM. Women with GDM were older, delivered earlier, with higher rates of mild preeclampsia and induction of labor. Their neonates had higher mean birth weight percentile, and higher rates of hypoglycemia, phototherapy, fracture of the humerus (3.2 versus 1.1%, aOR 2.95, 95%CI 1.38-6.30), and subarachnoid hemorrhage (1.2 versus 0.3%, aOR 4.56, 95%CI 1.28-16.26). No difference was found with regards to the composite neonatal outcome (9.2 versus 11.1%, p = .34).

Conclusions

GDM is associated with a higher risk for certain birth injuries in VAD at ≥37 + 0 weeks of gestation, yet the overall risk of adverse neonatal outcomes is comparable to women without GDM.