Is gestational diabetes an independent risk factor of neonatal severe respiratory distress syndrome after 34 weeks of gestation? A prospective study

• DOI: 10.1007/s00404-017-4505-7
• Publication Date: 2017-09-25T08:14:12Z
• Authors: Isabelle Mortier; Julie Blanc; Barthelemy Tosello; Catherine Gire; Florence Bretelle; Xavier Carcopino
• Keywords: Adult; Gestational Age; [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics; Severity of Illness Index; 03 medical and health sciences; 0302 clinical medicine; Maternal obesity; Pregnancy; Risk Factors; Intensive Care Units, Neonatal; Humans; Prospective Studies; Gestational diabetes; Late preterm and term pregnancy; [SDV.MHEP.EM] Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism; 2. Zero hunger; Respiratory Distress Syndrome, Newborn; Neonatal severe respiratory distress syndrome; Cesarean Section; Infant, Newborn; Pregnancy Outcome; [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism; Respiration, Artificial; 3. Good health; [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics; Diabetes, Gestational; [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie; Premature Birth; [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie; Female

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).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.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).GD is an independent risk factor of neonatal SRDS after 340/7 weeks.