Isabelle Mortier1, Julie Blanc2,3, Barthelemy Tosello4,5, Catherine Gire4, Florence Bretelle1,5, Xavier Carcopino1,6. 1. Department of Obstetrics and Gynaecology, Hôpital Nord, APHM, chemin des Bourrely, 13015, Marseille, France. 2. Department of Obstetrics and Gynaecology, Hôpital Nord, APHM, chemin des Bourrely, 13015, Marseille, France. julievirginie.blanc@ap-hm.fr. 3. EA 3279, Public Health, Chronic Diseases and Quality of Life, Research Unit, Aix-Marseille University, 13284, Marseille, France. julievirginie.blanc@ap-hm.fr. 4. Department of Neonatology, Hôpital Nord, APHM, chemin des Bourrely, 13015, Marseille, France. 5. URMITE, Aix-Marseille University (AMU), UM 63, CNRS 7278, IRD 198, INSERM 1095, Institut Hospitalo-Universitaire-Méditerranée Infection, 19-21 Bd Jean Moulin, 13385, Marseille Cedex 05, France. 6. Aix-Marseille University (AMU), CNRS, IRD IMBE UMR 7263, 13397, Marseille, France.
Abstract
PURPOSE: To evaluate if neonates delivered after 340/7 weeks from mothers diagnosed with gestational diabetes (GD) are exposed to an increased risk of neonatal severe respiratory distress syndrome (SRDS). METHODS: Women with singleton pregnancy in labour after 340/7 weeks of gestation or admitted for planned caesarean section and who had been systematically screened for GD were eligible to participate to this prospective cohort study. Diagnosis of SRDS was defined by the association of clinical signs of early neonatal respiratory distress, with consistent radiologic features and requiring mechanical ventilation with a fraction of inspired oxygen (FiO2) >0.25 for a minimum of 24 h and admission to neonatal intensive care unit. RESULTS: A total of 444 women were included. GD was diagnosed in 60 patients (13.5%). A neonatal SRDS was diagnosed in 32 cases (7.2%). Compared to others, neonatal SRDS was significantly more often observed in neonates from women diagnosed with GD: 12 (20%) vs. 20 (5.2%), respectively (p < 0.001). Women whose neonates presented neonatal SRDS were significantly more likely to be obese (p = 0.002), to have undergone a caesarean section (p < 0.001) and to have received corticosteroids therapy before 340/7 weeks (p = 0.013). In multivariate analysis, GD was identified as an independent risk factor of neonatal SRDS (aOR 3.6; 95% CI 1.5-8.6; p = 0.005). Other risk factors were maternal obesity (aOR 2.8; 95% CI 1.1-7.1; p = 0.029) and assisted vaginal delivery (aOR 5.5; 95% CI 1.9-15.9; p = 0.002). CONCLUSIONS: GD is an independent risk factor of neonatal SRDS after 340/7 weeks.
PURPOSE: To evaluate if neonates delivered after 340/7 weeks from mothers diagnosed with gestational diabetes (GD) are exposed to an increased risk of neonatal severe respiratory distress syndrome (SRDS). METHODS:Women with singleton pregnancy in labour after 340/7 weeks of gestation or admitted for planned caesarean section and who had been systematically screened for GD were eligible to participate to this prospective cohort study. Diagnosis of SRDS was defined by the association of clinical signs of early neonatal respiratory distress, with consistent radiologic features and requiring mechanical ventilation with a fraction of inspired oxygen (FiO2) >0.25 for a minimum of 24 h and admission to neonatal intensive care unit. RESULTS: A total of 444 women were included. GD was diagnosed in 60 patients (13.5%). A neonatal SRDS was diagnosed in 32 cases (7.2%). Compared to others, neonatal SRDS was significantly more often observed in neonates from women diagnosed with GD: 12 (20%) vs. 20 (5.2%), respectively (p < 0.001). Women whose neonates presented neonatal SRDS were significantly more likely to be obese (p = 0.002), to have undergone a caesarean section (p < 0.001) and to have received corticosteroids therapy before 340/7 weeks (p = 0.013). In multivariate analysis, GD was identified as an independent risk factor of neonatal SRDS (aOR 3.6; 95% CI 1.5-8.6; p = 0.005). Other risk factors were maternal obesity (aOR 2.8; 95% CI 1.1-7.1; p = 0.029) and assisted vaginal delivery (aOR 5.5; 95% CI 1.9-15.9; p = 0.002). CONCLUSIONS:GD is an independent risk factor of neonatal SRDS after 340/7 weeks.
Entities:
Keywords:
Gestational diabetes; Late preterm and term pregnancy; Maternal obesity; Neonatal severe respiratory distress syndrome
Authors: Beth A Plunkett; Grecio Sandoval; Jennifer L Bailit; Uma M Reddy; Ronald J Wapner; Michael W Varner; John M Thorp; Steve N Caritis; Mona Prasad; Alan T N Tita; George R Saade; Yoram Sorokin; Dwight J Rouse; Sean C Blackwell; Jorge E Tolosa Journal: Obstet Gynecol Date: 2019-09 Impact factor: 7.623