Over the last few decades, advances in diabetes management have made it safer than ever before for women with diabetes to have successful pregnancies and healthy babies. But there are still certain risks associated with having a baby when you have diabetes — and researchers are still trying to figure out exactly what they are, and when they apply.
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A team of researchers at the University of Toronto in Canada decided to look at what effect, if any, inducing labor had in a large group of pregnant women with diabetes that was diagnosed before their pregnancy — in other words, women with type 1 or type 2, but not gestational, diabetes. Their findings were published in the journal BMJ Open Diabetes Research & Care.
The study participants all gave birth between 2012 and 2017, and included 937 women who had labor induced at 38 weeks of gestation. Another 1,276 women did not have labor induced and gave birth at or after 39 weeks of gestation. The researchers were mostly interested in whether rates of cesarean delivery (C-section) were higher in either group, and found that they were nearly identical.
But the researchers did find differences in other outcomes. It was slightly more common for women who had labor induced to require instruments (such as forceps) to deliver their babies, at 11.2% versus 10.2% in the non-induced labor group. There was a much greater difference in the rate of admissions to the neonatal intensive care unit (NICU) between the two groups, with 27.6% of babies from the induced-labor group requiring admission, versus 16.8% from the non-induced labor group.
Rates of jaundice that required phototherapy were also higher in the induced-labor group, at 12.4% versus 6.2%, and newborn hypoglycemia (low blood glucose) was also more common, at 27.3% versus 14.7% in the non-induced labor group.
The researchers concluded that among many women with diabetes, letting a pregnancy continue to — or beyond — 39 weeks without inducing labor may improve certain outcomes in newborns, without increasing the risk of needing cesarean delivery.