Spontaneous labor curves in women with pregnancies complicated by diabetes

Abstract

Objective: To test the hypothesis that the first stage of labor will be longer in nulliparous and multiparous women with diabetes compared to non-diabetic counterparts. Methods: A retrospective analysis was performed from 228,668 deliveries between 2002–2008 from the Consortium of Safe Labor (National Institute of Child Health and Human Development, National Institutes of Health). Patients with spontaneous onset of labor from 37 0/7–41 6/7 weeks gestation were included (71,282) and classified as nulliparous or multiparous. Pregnancies were further subdivided regarding presence of preexisting diabetes (preDM) or gestational diabetes (GDM) and normal controls. Labor curves were created matching for body mass index (BMI) and neonatal birth weight. Statistical analysis was performed on descriptive variables using χ² with significance designated as p < 0.05. Results: Among nulliparous patients, there were 118 women with preDM and 475 women with GDM; 25,771 patients served as normal controls. Among multiparous women, there were 311 with preDM, 1,079 with GDM and 43,528 in the control group. Although differences in dilatation rates were observed in nulliparous and multiparous women with and without diabetes, labor progression was similar between the subgroups when matched for maternal BMI and birth weight. Conclusions: Labor curves of women with preDM and GDM approximate those of non-diabetics, regardless of BMI, birth weight, or parity.

Keywords::

• First stage
• gestational diabetes
• obesity
• second stage
• type 2 diabetes mellitus

Declaration of interest: Support for this study was provided by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH) (Contract No. HHSN267200603425C). Statistical support for this project was provided through the MedStar Health Research Institute, a component of the Georgetown-Howard Universities Center for Clinical and Translational Science and supported by Grant 1UL1RR031975 from the National Center for Research Resources (NCRR), a component of the NIH. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NCRR or NIH.