Factors influencing neonatal morbidity in gestational diabetic pregnancy

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Abstract
Summary. The influence of obstetric factors and indices of maternal blood glucose control on neonatal morbidity was examined in 261 women with gestational diabetes. A reference group of 218 women, matched for age and day of delivery, within 1 week, was used for comparison. Perinatal morbidity was significantly more frequent in the gestational diabetic pregnancies (23%) than in the reference group (13%), whereas the occurrence of large‐for‐gestational‐age infants was not different between the groups. Infants born to women with gestational diabetes were categorized to a no‐morbidity group (n=200) and a morbidity group (n=61). The group with morbidity had significantly shorter gestational age at delivery, higher frequency of caesarean section, higher maternal pre‐pregnancy weight and higher area under the glucose tolerance curve. There was no significant difference in third‐trimester blood glucose between the groups. Discriminant analysis revealed that the most significant influence on neonatal morbidity was gestational age at delivery. After correction for this factor the only factor with added significance for neonatal morbidity was maternal pre‐pregnancy weight. The present study clearly illustrates that other factors beside blood glucose control are of importance for neonatal outcome in gestational diabetic pregnancy.