ArticleActa obstetricia et gynecologica Scandinavica2020
Timing of delivery in women with diabetes: A population-based study.
Article in Acta obstetricia et gynecologica Scandinavica, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Preexisting Diabetes and Pregnancy: An Endocrine Society and European Society of Endocrinology Joint Clinical Practice Guideline.The Journal of clinical endocrinology and metabolism · 2025Guideline
- Article
- Procedural abortion, provider-initiated preterm delivery and survival in pregnant people with cancer: A population-based cohort study.BJOG : an international journal of obstetrics and gynaecology · 2025Article
- Antepartum Fetal Surveillance and Optimal Timing of Delivery in Diabetic Women: A Narrative Review.Journal of clinical medicine · 2024Review
- Factors Affecting Mode of Birth in Women With Preexisting Diabetes and Gestational Diabetes: A Retrospective Cohort at a Tertiary Referral Center.Journal of diabetes research · 2024Article
- Neonatal outcomes and rationale for timing of birth in perinatal diabetes: a retrospective cohort study.American journal of obstetrics & gynecology MFM · 2023Article
- Gestational diabetes mellitus: The optimal time of delivery.World journal of diabetes · 2023Review
- Management of type 2 diabetes in pregnancy: a narrative review.Frontiers in endocrinology · 2023Review
- A Clinical Update on Gestational Diabetes Mellitus.Endocrine reviews · 2022Article
- Predictors of a successful vaginal delivery in women with type 1 diabetes: a retrospective analysis of 20 years.Archives of gynecology and obstetrics · 2022Article
- Maternal and Fetal Outcomes in Women with Diabetes in Pregnancy Treated before and after the Introduction of a Standardized Multidisciplinary Management Protocol.Journal of diabetes research · 2021Article
- Timing of delivery in women with diabetes: A population-based study.Acta obstetricia et gynecologica Scandinavica · 2020Article
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Authors and funding
7 authors.
Funding
Abstract
introductionWomen with diabetes, and their infants, have an increased risk of adverse events due to excess fetal growth. Earlier delivery, when fetuses are smaller, may reduce these risks. This study aimed to evaluate the week-specific risks of maternal and neonatal morbidity/mortality to assist with obstetrical decision making. MATERIAL AND
methodsIn this population-based cohort study, women with type 1 diabetes (n = 5889), type 2 diabetes (n = 9422) and gestational diabetes (n = 138 917) and a comparison group without diabetes (n = 2 553 243) who delivered a singleton infant at ≥36 completed weeks of gestation between 2004 and 2014 were identified from the Canadian Institute of Health Information Discharge Abstract Database. Multivariate logistic regression was used to determine the week-specific rates of severe maternal and neonatal morbidity/mortality among women delivered iatrogenically vs those undergoing expectant management.
resultsFor all women, the absolute risk of severe maternal morbidity/mortality was low, typically impacting less than 1% of women, and there was no significant difference in gestational age-specific severe maternal morbidity/mortality between iatrogenic delivery and expectant management among women with any form of diabetes. Among women with gestational diabetes, iatrogenic delivery was associated with an increased risk of neonatal morbidity/mortality compared with expectant management at 36 and 37 weeks' gestation (76.7 and 27.8 excess cases per 1000 deliveries, respectively) and a lower risk of neonatal morbidity/mortality at 38, 39 and 40 weeks' gestation (7.9, 27.3 and 15.9 fewer cases per 1000 deliveries, respectively). Increased risks of severe neonatal morbidity following iatrogenic delivery compared with expectant management were also observed for women with type 1 diabetes at 36 (98.3 excess cases per 1000 deliveries) and 37 weeks' gestation (44.5 excess cases per 1000 deliveries) and for women with type 2 diabetes at 36 weeks' gestation (77.9 excess cases per 1000 deliveries) weeks.
conclusionsThe clinical decision regarding timing of delivery is complex and contingent on maternal-fetal wellbeing, including adequate glycemic control. This study suggests that delivery at 38, 39 or 40 weeks' gestation may optimize neonatal outcomes among women with diabetes.
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