title: Spontaneous labor curves in women with pregnancies complicated by diabetes.
abstract: OBJECTIVE
  To test the hypothesis that the first stage of labor will be longer in nulliparous and multiparous women with diabetes compared to non-diabetic counterparts.
  
  
  METHODS
  A retrospective analysis was performed from 228,668 deliveries between 2002-2008 from the Consortium of Safe Labor (National Institute of Child Health and Human Development, National Institutes of Health). Patients with spontaneous onset of labor from 37 0/7-41 6/7 weeks gestation were included (71,282) and classified as nulliparous or multiparous. Pregnancies were further subdivided regarding presence of preexisting diabetes (preDM) or gestational diabetes (GDM) and normal controls. Labor curves were created matching for body mass index (BMI) and neonatal birth weight. Statistical analysis was performed on descriptive variables using χ(2) with significance designated as p < 0.05.
  
  
  RESULTS
  Among nulliparous patients, there were 118 women with preDM and 475 women with GDM; 25,771 patients served as normal controls. Among multiparous women, there were 311 with preDM, 1,079 with GDM and 43,528 in the control group. Although differences in dilatation rates were observed in nulliparous and multiparous women with and without diabetes, labor progression was similar between the subgroups when matched for maternal BMI and birth weight.
  
  
  CONCLUSIONS
  Labor curves of women with preDM and GDM approximate those of non-diabetics, regardless of BMI, birth weight, or parity.
authors.affiliation: Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Washington Hospital Center, MedStar Health, Washington, DC 20010, USA. julia.timofeev@medstar.net
authors.forename: Julia
authors.initials: J
authors.lastname: Timofeev
authors.forename: Chun-Chih
authors.initials: CC
authors.lastname: Huang
authors.forename: Jasbir
authors.initials: J
authors.lastname: Singh
authors.forename: Rita W
authors.initials: RW
authors.lastname: Driggers
authors.forename: Helain J
authors.initials: HJ
authors.lastname: Landy
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000503:physiopathology; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric / Q000502:physiology*; D009316:National Institutes of Health (U.S.); D010298:Parity; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000503:physiopathology*; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States