Intrapartal cardiotocographic patterns and hypoxia-related perinatal outcomes in pregnancies complicated by gestational diabetes mellitus

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Tarvonen , M , Hovi , P , Sainio , S , Vuorela , P , Andersson , S & Teramo , K 2021 , ' Intrapartal cardiotocographic patterns and hypoxia-related perinatal outcomes in pregnancies complicated by gestational diabetes mellitus ' , Acta Diabetologica , vol. 58 , no. 11 , pp. 1563-1573 . https://doi.org/10.1007/s00592-021-01756-0

Title: Intrapartal cardiotocographic patterns and hypoxia-related perinatal outcomes in pregnancies complicated by gestational diabetes mellitus
Author: Tarvonen, Mikko; Hovi, Petteri; Sainio, Susanna; Vuorela, Piia; Andersson, Sture; Teramo, Kari
Contributor organization: Department of Obstetrics and Gynecology
HUS Gynecology and Obstetrics
HUS Children and Adolescents
Clinicum
Children's Hospital
Date: 2021-11
Language: eng
Number of pages: 11
Belongs to series: Acta Diabetologica
ISSN: 0940-5429
DOI: https://doi.org/10.1007/s00592-021-01756-0
URI: http://hdl.handle.net/10138/340540
Abstract: Aims In previous reports, cardiotocographic (CTG) fetal heart rate (FHR) monitoring has shown only limited benefits in decreasing adverse perinatal outcomes in pregnancies complicated by gestational diabetes mellitus (GDM). The aim of the present study was to evaluate whether an association exists between the recently reported ZigZag pattern (FHR baseline amplitude changes of > 25 bpm with a duration of 2-30 min) and asphyxia-related neonatal outcomes in GDM pregnancies. Methods Intrapartal CTGs were recorded in a one-year cohort of 5150 singleton childbirths. The following CTG changes were evaluated: ZigZag pattern, saltatory pattern, late decelerations, episodes of tachycardia and bradycardia, reduced variability, and uterine tachysystole. The cohort was divided into three groups: women with GDM, women with normal oral glucose tolerance test (OGTT), and women with no OGTT performed. Umbilical artery (UA) blood gases, Apgar scores, neonatal respiratory distress, and neonatal encephalopathy were used as outcome variables. Results GDM was diagnosed in 624 (12.1%), OGTT was normal in 4115 (79.9%), and OGTT was not performed in 411 (8.0%) women. Hypoxia-related ZigZag patterns (OR 1.94, 95% CI 1.64-2.34) and late decelerations (OR 1.65, 95% CI 1.27-2.13) of FHR, as well as a greater risk of fetal asphyxia (UA pH < 7.10 and/or UA BE < -12.0 meq/L and/or Apgar scores < 7 at 5-min) (OR 6.64, 95% CI 1.84-12.03) were observed in those with GDM compared with those without GDM. Conclusions GDM is associated with intrapartal ZigZag pattern and late decelerations, cord blood acidemia and low 5-min Apgar scores at birth indicating increased occurrence of fetal hypoxia in GDM pregnancies.
Subject: Birth cohort
Intrapartum cardiotocography
Fetal heart rate
Fetal asphyxia
Gestational diabetes mellitus
Perinatal outcome
FETAL HEART-RATE
LABOR
HYPERGLYCEMIA
WOMEN
CLASSIFICATION
MULTICENTER
PLASMA
COHORT
OXYGEN
RISK
3123 Gynaecology and paediatrics
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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