Severe birth injuries in neonates and associated risk factors for injury in mothers with different types of diabetes in Finland. Issue 1 (7th January 2022)

• Record Type: Journal Article
• Authors: Kekki, Maiju; Tihtonen, Kati; Salonen, Anne; Koukkula, Topias; Gissler, Mika; Laivuori, Hannele; Huttunen, Tuomas T.
• Is Part Of: International journal of gynaecology and obstetrics. Volume 159:Issue 1(2022)
• Page Start: 195
• Page End: 203
• Publication Date: 2022-01-07
• Subjects: brachial plexus injury -- gestational diabetes -- pregestational diabetes -- severe birth injury -- vaginal delivery; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.14073
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To examine severe birth‐related injuries in neonates among mothers with different types of diabetes. Methods: Retrospective cohort study based on Finnish Medical Birth Register data from 2004 to 2017. The study included singleton neonates born vaginally with cephalic presentation ( n = 623 649) after 35 +0 weeks of gestation. The primary outcome variable was severe birth injury. Incidences, crude and adjusted odds ratios, and probabilities in regression analysis were calculated for different types of diabetes. Results: There were 1952/623 649 (0.3%) severe birth injuries of which brachial plexus injury occurred most frequently. The injury incidence was highest in neonates of women with type 1 or type 2 diabetes, 42/1659 (2.5%) and 10/548 (1.8%), respectively. For gestational diabetes, the injury incidence was comparable to non‐diabetic women: 422/77 810 (0.5%) and 1478/543 632 (0.3%), respectively. Shoulder dystocia, high birthweight, and vacuum‐assisted delivery were associated with the highest probability for injury. Birthweight and obesity had a stronger impact on injury risk in women with pregestational diabetes compared to other pregnancies. Conclusion: Neonates of women with pregestational diabetes have a higher risk for severe birth injury than other neonates. The injury risk in neonates delivered by women with gestational diabetes or non‐diabetic women is generally low. Abstract : Incidence of neonatal severe birth injury was highest in pregnancies with pregestational diabetes. However, in women with gestational diabetes, it was comparable to non‐diabetic women.