Increased Neonatal Respiratory Morbidity Associated with Gestational and Pregestational Diabetes: A Retrospective Study.

OBJECTIVE

: To examine risk of neonatal respiratory morbidity associated with gestational and pregestational diabetes, accounting for the prematurity-associated risk using a propensity score analysis.

STUDY

DESIGN

: In a retrospective study including 222,978 singleton pregnancies, delivering at 24 0/7–41 6/7 weeks (2002–2008), we calculated a probability to deliver at term (≥ 37 weeks’ gestation). Outcomes were stratified by the probability to deliver at term (>0.8 and ≤0.8). Adjusted odds ratios (aOR) with 95% confidence intervals (95%CI) were calculated.

RESULTS

: Gestational and pregestational diabetes complicated 5.1% and 1.5% of pregnancies, respectively and were associated with increased risks of neonatal respiratory morbidity compared to women without diabetes regardless of probability to deliver at term, although the risks tended to be higher with a higher probability to deliver at term: respiratory distress syndrome: aOR 1.5; 95%CI 1.3–1.7 and aOR 3.1; 95%CI 2.6–3.7; transient tachypnea of newborn aOR 1.5; 95%CI 1.3–1.6, and aOR 2.2; 95%CI 1.9–2.6; and apnea aOR 1.5; 95%CI 1.2–1.7 and aOR 3.2; 95%CI 2.6–3.9, for gestational and pregestational at term, respectively.

CONCLUSION

: Diabetes was associated with increased risk of neonatal respiratory morbidity beyond what can be attributed to prematurity. Neonatal respiratory morbidities were increased with pregestational compared with gestational diabetes.