Adjusted ORs for adverse neonatal outcomes of TSV born to women with diabetes during pregnancy by mode of birth, 2002–2012
| Non-instrumental vaginal birth† | Instrumental vaginal birth | Intrapartum caesarean section | Prelabour caesarean section | ||||||||
| n | (%) | n | (%) | AOR‡ (95% CI) | n | (%) | AOR‡ (95% CI) | n | % | AOR‡ (95% CI) | |
| Pre-existing diabetes | |||||||||||
| Birth weight less than 4000 g | 1647 | 338 | 628 | 880 | |||||||
| 5 min Apgar score <7 | 19 | 1.2 | 6 | 1.8 | 1.7 (0.6 to 4.5) | 12 | 1.9 | 1.6 (0.7 to 3.6) | 10 | 1.1 | 0.9 (0.4 to 2.1) |
| Admitted to NICU/SCN | 633 | 38.4 | 170 | 50.3 | 1.8* (1.4 to 2.3) | 377 | 60.0 | 2.4* (2.0 to 3.0) | 495 | 56.3 | 2.1* (1.8 to 2.5) |
| Need for resuscitation§ | 74 | 4.5 | 46 | 13.6 | 3.3* (2.2 to 5.0) | 63 | 10.0 | 2.3* (1.6 to 3.4) | 51 | 5.8 | 1.3 (0.9 to 1.9) |
| Birth weight 4000 g and over | 310 | 54 | 210 | 391 | |||||||
| 5 min Apgar score <7 | 12 | 3.9 | 3 | 5.6 | 0.8 (0.2 to 3.7) | 1 | 0.5 | 0.1* (0.0 to 0.5) | 1 | 0.3 | 0.1* (0.0 to 0.5) |
| Admitted to NICU/SCN | 137 | 44.2 | 34 | 63.0 | 2.1* (1.1 to 3.9) | 158 | 75.2 | 3.9* (2.6 to 5.9) | 285 | 72.9 | 4.1* (2.9 to 5.7) |
| Need for resuscitation§ | 32 | 10.3 | 14 | 25.9 | 2.6* (1.2 to 5.7) | 30 | 14.3 | 1.3 (0.7 to 2.3) | 32 | 8.2 | 0.8 (0.5 to 1.4) |
| Gestational diabetes | |||||||||||
| Birth weight less than 4000 g | 22 304 | 4565 | 5461 | 6590 | |||||||
| 5 min Apgar score <7 | 177 | 0.8 | 87 | 1.9 | 2.4* (1.8 to 3.1) | 98 | 1.8 | 2.1* (1.6 to 2.7) | 62 | 0.9 | 1.3 (0.9 to 1.7) |
| Admitted to NICU/SCN | 5299 | 23.8 | 1354 | 29.7 | 1.5* (1.4 to 1.6) | 1960 | 35.9 | 1.9* (1.7 to 2.0) | 2107 | 32.0 | 1.6* (1.5 to 1.7) |
| Need for resuscitation§ | 822 | 3.7 | 433 | 9.5 | 2.5* (2.2 to 2.9) | 497 | 9.1 | 2.3* (2.1 to 2.7) | 326 | 4.9 | 1.5* (1.3 to 1.7) |
| Birth weight 4000 g and over | 2539 | 426 | 946 | 1317 | |||||||
| 5 min Apgar score <7 | 49 | 1.9 | 14 | 3.3 | 1.8 (0.9 to 3.5) | 13 | 1.4 | 0.7 (0.3 to 1.3) | 22 | 1.7 | 1.0 (0.6 to 1.7) |
| Admitted to NICU/SCN | 752 | 29.6 | 138 | 32.4 | 1.3* (1.0 to 1.7) | 398 | 42.1 | 1.9* (1.6 to 2.3) | 610 | 46.3 | 2.3* (2.0 to 2.7) |
| Need for resuscitation§ | 259 | 10.2 | 76 | 17.8 | 2.3* (1.7 to 3.1) | 88 | 9.3 | 1.0 (0.7 to 1.3) | 99 | 7.5 | 0.7* (0.6 to 0.9) |
*P<0.05.
†Reference group.
‡ORs were adjusted for maternal age, maternal country of birth, the number of previous pregnancies, smoking during pregnancy, essential and pregnancy-induced hypertension and hospital sector.
§Need for resuscitation includes intermittent positive pressure respiration by bag and mask, intubation and intermittent positive pressure respiration as well as external cardiac massage and ventilation.
AOR, adjusted OR; NICU, neonatal intensive care unit; SCN, special care nursery; TSV, term singletons in vertex presentation.