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

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dc.contributor.author Tarvonen, Mikko
dc.contributor.author Hovi, Petteri
dc.contributor.author Sainio, Susanna
dc.contributor.author Vuorela, Piia
dc.contributor.author Andersson, Sture
dc.contributor.author Teramo, Kari
dc.date.accessioned 2022-02-17T10:54:01Z
dc.date.available 2022-02-17T10:54:01Z
dc.date.issued 2021-11
dc.identifier.citation 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
dc.identifier.other PURE: 167717034
dc.identifier.other PURE UUID: 205361f2-ea8c-426f-b218-f4d451477b52
dc.identifier.other WOS: 000664316500001
dc.identifier.uri http://hdl.handle.net/10138/340540
dc.description.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. en
dc.format.extent 11
dc.language.iso eng
dc.relation.ispartof Acta Diabetologica
dc.rights cc_by
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Birth cohort
dc.subject Intrapartum cardiotocography
dc.subject Fetal heart rate
dc.subject Fetal asphyxia
dc.subject Gestational diabetes mellitus
dc.subject Perinatal outcome
dc.subject FETAL HEART-RATE
dc.subject LABOR
dc.subject HYPERGLYCEMIA
dc.subject WOMEN
dc.subject CLASSIFICATION
dc.subject MULTICENTER
dc.subject PLASMA
dc.subject COHORT
dc.subject OXYGEN
dc.subject RISK
dc.subject 3123 Gynaecology and paediatrics
dc.title Intrapartal cardiotocographic patterns and hypoxia-related perinatal outcomes in pregnancies complicated by gestational diabetes mellitus en
dc.type Article
dc.contributor.organization Department of Obstetrics and Gynecology
dc.contributor.organization HUS Gynecology and Obstetrics
dc.contributor.organization HUS Children and Adolescents
dc.contributor.organization Clinicum
dc.contributor.organization Children's Hospital
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1007/s00592-021-01756-0
dc.relation.issn 0940-5429
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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