Optimal delivery times for gestational diabetes: a problem requiring a consensus solution

• Papysheva Olga V.
• Esipova Larisa N.
• Nadezhda M. Startseva
• Lukanovskaya Olga B.
• Irina V. Savenkova
• Gayane A. Arakelyan
• Mayatskaya Tatyana A.
• Kotaysh Galina A.

Abstract

The main problem of the delivery of pregnant women with gestational diabetes mellitus (GDM) is the search for the optimal period to find a balance between enough fetal maturity and the lack of decompensation of placental insufficiency, diabetic fetopathy (DF).

Aim - to study the state of health of full-term newborns from mothers with GDM, depending on the timing of delivery.

Material and methods. A retrospective analysis of childbirth histories of 286 pregnant women with GDM and development cards of their newborns in 2017-2019 at the maternity ward of the City Clinical Hospital No. 29 named by N.E. Bauman in Moscow at full term gestation.

Results. The frequency of morphological and functional immaturity in children from mothers with GDM on insulin therapy, born at 39 weeks 1 day - 40.0 weeks 1.5 times lower, perinatal CNS damage - 3.3 times, hypoglycemia in the early neonatal period - 1.4 times, respiratory distress syndrome - 16 (!) times, hyperbilirubinemia - 1.8 times, compared with those born at 37.0-38.0 weeks. In newborns from mothers on diet therapy who were born at 40.0-41.0 weeks with a minimum frequency, they encountered: CNS depression syndrome (2.1 times less than 38 weeks 1 day - 39.0 weeks), hyperbilirubinemia (2.8 times less than 38 weeks 1 day - 39.0 weeks), hypoglycemia was not observed.

Conclusion. For GDM on insulin therapy, the optimal delivery period can be considered 39.1-40.0 weeks, on diet therapy - 40 weeks 1 day - 41.0 weeks.

Keywords:gestational diabetes mellitus, diabetic fetopathy, delivery time

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