title: Short-term neonatal outcome in diabetic versus non-diabetic pregnancies complicated by non-reassuring foetal heart rate tracings.
abstract: OBJECTIVE
  Analysis of the impact of non-reassuring foetal heart rate patterns (FHR) and suspected foetal distress during active labour on the neonatal outcome in diabetic compared to non-diabetic mothers.
  
  
  METHODS
  Retrospective case-control study comparing the short-term neonatal outcome including Apgar score at 5 min, and arterial/venous umbilical cord blood pH of 57 deliveries of women with different types of diabetes and 114 healthy controls. Patients were selected out of all deliveries with suspected foetal distress during active labour and performed foetal scalp pH samplings (n = 590) at the Medical University of Graz, Austria, during 2008-2009.
  
  
  RESULTS
  Arterial pH was significantly lower in the diabetic group (7.215 versus 7.250, p = 0.007). Apgar scores ( > 8) at 5 min were similar in both groups (96.5% versus 95.6%, p = 0.566). The percentage of cases with foetal scalp blood pH <7.25 was higher in the diabetes group, but did not reach statistical significance (14.1% versus 7.1%, p = 0.166).
  
  
  CONCLUSIONS
  Newborns of women with gestational and type 1 diabetes and non-reassuring FHR tracing have significantly lower arterial cord blood pH values without consequences on neonatal postpartum adaptation. Special attention to pathological changes in FHR patterns and to the more rapid decline in foetal pH during periods of foetal distress may be warranted in women with gestational and pre-conceptional diabetes during active labour. More frequent foetal scalp pH testing to rule out clinically relevant foetal acidosis needs to be discussed.
authors.affiliation: Department of Obstetrics and Gynaecology and.
authors.forename: Philipp
authors.initials: P
authors.lastname: Reif
authors.forename: Thomas
authors.initials: T
authors.lastname: Panzitt
authors.forename: Franz
authors.initials: F
authors.lastname: Moser
authors.forename: Bernhard
authors.initials: B
authors.lastname: Resch
authors.forename: Josef
authors.initials: J
authors.lastname: Haas
authors.forename: Uwe
authors.initials: U
authors.lastname: Lang
mesh_terms: D000138:Acidosis / Q000097:blood; D000328:Adult; D001034:Apgar Score; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005315:Fetal Diseases / Q000097:blood; D005316:Fetal Distress / Q000503:physiopathology; D005323:Fetal Monitoring; D006340:Heart Rate, Fetal; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007743:Labor, Obstetric; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D012535:Scalp / Q000098:blood supply / Q000196:embryology