title: Labor and neonatal outcomes after term induction of labor in gestational diabetes.
abstract: OBJECTIVE
  To identify the optimal gestational age (GA) for induction of labor (IOL) at term among patients with gestational diabetes (GDMA) according to perinatal outcomes.
  
  
  METHODS
  The US Natality Database from 2007 to 2010 was reviewed. Inclusion criteria were singleton delivery, IOL at 37 to 42 weeks and GDMA. Exclusion criteria included congenital anomalies, pre-gestational diabetes, hypertensive disorders, previous cesarean, breech presentation and rupture of membranes. Controls were non-GDMA cases delivered in geographic and temporal proximity. Delivery mode, macrosomia and perinatal complications were analyzed. Logistic regression adjusted for confounders was used to calculate odds ratios by GA using 39 weeks non-GDMA as reference.
  
  
  RESULTS
  In all, 96,964 cases and 176,079 controls were included. Increased risk for all adverse outcomes among GDMA cases was found. The nadir for intrapartum and neonatal complications was 38 and 40 weeks, respectively, whereas for cesarean and macrosomia was 39 weeks.
  
  
  CONCLUSIONS
  The optimal timing for IOL at term in GDMA appears to be 39 to 40 weeks.
authors: Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA.
authors: G A
authors: GA
authors: Vilchez
authors: C.S Mott Center for Human Growth and Development, Wayne State University, Detroit, MI, USA.
authors: J
authors: J
authors: Dai
authors: Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA.
authors: L R
authors: LR
authors: Hoyos
authors: Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA.
authors: N
authors: N
authors: Gill
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
authors: R
authors: R
authors: Bahado-Singh
authors: Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA.
authors: R J
authors: RJ
authors: Sokol
mesh_terms: D000328:Adult; D001724:Birth Weight; D002585:Cesarean Section / Q000379:methods; D015331:Cohort Studies; D016208:Databases, Factual; D036861:Delivery, Obstetric / Q000379:methods*; D016640:Diabetes, Gestational / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000068104:Infant Health; D007231:Infant, Newborn; D007751:Labor, Induced / Q000009:adverse effects / Q000379:methods*; D016015:Logistic Models; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D047929:Term Birth; D014481:United States