Maternal and Neonatal Characteristics Associated with Failed Induction of Labor in Diabetic Mothers

Document Type

Conference Proceeding

Publication Date

5-2024

Publication Title

Obstetrics and Gynecology

Abstract

INTRODUCTION: Uncontrolled diabetes is a risk factor for cesarean delivery. Identifying and stratifying associated risk factors for failed induction of labor (IOL) may improve counseling and intrapartum care. This study aims at determining maternal and fetal factors that would predict the occurrence of failed IOL in diabetic mothers. METHODS: This is a retrospective study of 2,172 diabetic mothers who underwent IOL at a single university medical center between January 2013 and December 2021. Maternal and neonatal characteristics were obtained. Among the studied maternal characteristics were ethnicity, age, gestational age, medical comorbidities (including preeclampsia and essential hypertension), insulin administration, parity and health insurance type (public versus private). Statistical analysis was performed using univariate and multivariate logistic regression. A value of P,.05 was considered statistically significant. RESULTS: Our preliminary analysis showed that 567 out of 2,172 (26.1%) diabetic mothers failed IOL and delivered via cesarean pathway. Failed IOL was associated with nulliparity (P5.0001), preexisting diabetes (compared to gestational diabetes) (P5.001), control of diabetes by insulin (P5.001), maternal essential hypertension (P5.001), preeclampsia (P5.001), polyhydramnios (P5.001), prenatal diagnosis of fetal growth restriction (P5.008), and placental abnormalities (P5.027). Neonatal weight, large for gestational age, head circumference, and height were not statistically associated with failed induction of labor (all values of P..05). Failed IOL was associated with admission to neonatal intensive care unit (P5.001), hyperbilirubinemia (P5.001), lower APGAR score at 1 minute (P5.033), longer stay in the hospital (0.001). Failed IOL was not associated with lower APGAR score at 5 minutes, lower umbilical cord pH value, neonatal readmission or maternal ethnicity (all values of P..05). CONCLUSION: Failed IOL among diabetic mothers is associated with significant maternal and neonatal adverse outcomes. Our continued data analysis aims at assessing the role of optimal glucose control and other maternal factors in improving maternal and neonatal outcomes.

Volume

143

Issue

5S

First Page

32S

Comments

72nd Annual Clinical and Scientific Meeting of the American College of Obstetricians and Gynecologists, May 17-19, 2024, San Francisco, CA

DOI

10.1097/01.AOG.0001013364.58698.94

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