Randomized controlled trial of induction at 38 weeks versus 40 weeks gestation on maternal and infant outcomes in women with insulin-controlled gestational diabetes.
OBJECTIVE
To compare the impact of induction of labor at 38 weeks of gestation with the induction of labor at 40 weeks of gestation in women with insulin-treated gestational diabetes on maternal and fetal outcome.


METHODS
In this study 100 pregnant women with insulin-treated gestational diabetes were randomized to either induction of labor at 38 (group I) or 40 weeks (group II) to evaluate the rate of large for gestational age newborns, neonatal hypoglycemia, success rate of deliveries within 48 h and cesarean section rate after induction in both groups.


RESULTS
The difference of large for gestational age newborns was not significant between the two groups (6.8% vs. 12.8%, p = 0.49), 16 (36.4%) newborns in group I and 8 (17.0%) newborns in group II developed hypoglycemia <35 mg/dl (p = 0.04). The success rate for deliveries within 48 h after induction of labor for groups I and II was 77.3% and 92.3%, respectively (p = 0.25). The cesarean section rate after induction of labor was not significantly different between the two groups (24.1% vs. 18.7%, p = 0.49).


CONCLUSIONS
In a cohort of women with insulin-treated gestational diabetes, induction of labor at 38 weeks did not significantly reduce the rate of large for gestational age newborns compared to induction at 40 weeks but seems to increase the rate of neonatal hypoglycemia.
Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
Katharina
K
Worda
Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
Dagmar
D
Bancher-Todesca
Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
Peter
P
Husslein
Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
Christof
C
Worda
Department of Obstetrics and Gynecology, General Hospital of Klagenfurt, St. Veiterstraße 47, 9020, Klagenfurt, Austria. heinz.leipold@kabeg.at.
Heinz
H
Leipold
D000328:Adult; D001663:Bilirubin / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D016640:Diabetes, Gestational / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005320:Fetal Macrosomia / Q000097:blood / Q000209:etiology; D005865:Gestational Age; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood / Q000209:etiology*; D007328:Insulin / Q000627:therapeutic use*; D007363:Intensive Care Units, Neonatal; D007751:Labor, Induced; D010343:Patient Admission; D063868:Patient Outcome Assessment; D011247:Pregnancy
D001663:Bilirubin; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human
Gestational diabetes; Induced labor