Association of Gestational Diabetes Mellitus with Neonatal Respiratory Morbidity

Erika F. Werner*, Megan E. Romano, Dwight J. Rouse, Grecio Sandoval, Cynthia Gyamfi-Bannerman, Sean C. Blackwell, Alan T.N. Tita, Uma M. Reddy, Lucky Jain, George R. Saade, Jay D. Iams, Erin A.S. Clark, John M. Thorp, Edward K. Chien, Alan M Peaceman, Geeta K. Swamy, Mary E. Norton, Brian M. Casey, Steve N. Caritis, Jorge E. Tolosa & 1 others Yoram Sorokin

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

OBJECTIVE:To assess neonatal respiratory morbidity in pregnancies with and without gestational diabetes mellitus (GDM) at imminent risk of late preterm delivery in a modern U.S. cohort.METHODS:Secondary analysis of a randomized placebo-controlled trial in which women with singleton pregnancies at high risk for delivery between 34 0/7 and 36 5/7 weeks of gestation were allocated to betamethasone or placebo. The primary outcome for the trial and this secondary analysis was a composite outcome of neonatal respiratory morbidity in the first 72 hours of life. Secondary outcomes included neonatal severe respiratory complications, neonatal intensive care unit (NICU) admission greater than or equal to 3 days, and hyperbilirubinemia. We examined associations between neonatal morbidities and GDM status after adjustment for baseline differences and study group allocation using modified Poisson regression. Models incorporating a product interaction term between GDM status and treatment arm (betamethasone or placebo) were also evaluated.RESULTS:Of the 2,831 women enrolled in the trial, 306 (10.8%) had GDM. Women with GDM were significantly older and were more likely to be parous and to have hypertensive disorders of pregnancy than those without GDM, but they were similar regarding race, gestational age at randomization (35.6 weeks) and at delivery (36.1 weeks), and study group assignment. Neonates born to women with GDM were no more likely to meet the primary outcome than those born to women without GDM, even after adjusting for differences in age, parity, and hypertensive disorders of pregnancy (12.1% vs 13.1%, adjusted RR 0.84; 95% CI 0.61-1.17), nor were they more likely to have severe respiratory complications or prolonged NICU admission.CONCLUSION:Maternal GDM is not associated with increased neonatal respiratory morbidity in this study population who were at high risk for late preterm birth.

Original languageEnglish (US)
Pages (from-to)349-353
Number of pages5
JournalObstetrics and gynecology
Volume133
Issue number2
DOIs
StatePublished - Feb 1 2019
Externally publishedYes

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Gestational Diabetes
Morbidity
Betamethasone
Pregnancy
Neonatal Intensive Care Units
Placebos
High-Risk Pregnancy
Hyperbilirubinemia
Premature Birth
Random Allocation
Parity
Gestational Age
Randomized Controlled Trials
Mothers
Newborn Infant

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Werner, E. F., Romano, M. E., Rouse, D. J., Sandoval, G., Gyamfi-Bannerman, C., Blackwell, S. C., ... Sorokin, Y. (2019). Association of Gestational Diabetes Mellitus with Neonatal Respiratory Morbidity. Obstetrics and gynecology, 133(2), 349-353. https://doi.org/10.1097/AOG.0000000000003053
Werner, Erika F. ; Romano, Megan E. ; Rouse, Dwight J. ; Sandoval, Grecio ; Gyamfi-Bannerman, Cynthia ; Blackwell, Sean C. ; Tita, Alan T.N. ; Reddy, Uma M. ; Jain, Lucky ; Saade, George R. ; Iams, Jay D. ; Clark, Erin A.S. ; Thorp, John M. ; Chien, Edward K. ; Peaceman, Alan M ; Swamy, Geeta K. ; Norton, Mary E. ; Casey, Brian M. ; Caritis, Steve N. ; Tolosa, Jorge E. ; Sorokin, Yoram. / Association of Gestational Diabetes Mellitus with Neonatal Respiratory Morbidity. In: Obstetrics and gynecology. 2019 ; Vol. 133, No. 2. pp. 349-353.
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abstract = "OBJECTIVE:To assess neonatal respiratory morbidity in pregnancies with and without gestational diabetes mellitus (GDM) at imminent risk of late preterm delivery in a modern U.S. cohort.METHODS:Secondary analysis of a randomized placebo-controlled trial in which women with singleton pregnancies at high risk for delivery between 34 0/7 and 36 5/7 weeks of gestation were allocated to betamethasone or placebo. The primary outcome for the trial and this secondary analysis was a composite outcome of neonatal respiratory morbidity in the first 72 hours of life. Secondary outcomes included neonatal severe respiratory complications, neonatal intensive care unit (NICU) admission greater than or equal to 3 days, and hyperbilirubinemia. We examined associations between neonatal morbidities and GDM status after adjustment for baseline differences and study group allocation using modified Poisson regression. Models incorporating a product interaction term between GDM status and treatment arm (betamethasone or placebo) were also evaluated.RESULTS:Of the 2,831 women enrolled in the trial, 306 (10.8{\%}) had GDM. Women with GDM were significantly older and were more likely to be parous and to have hypertensive disorders of pregnancy than those without GDM, but they were similar regarding race, gestational age at randomization (35.6 weeks) and at delivery (36.1 weeks), and study group assignment. Neonates born to women with GDM were no more likely to meet the primary outcome than those born to women without GDM, even after adjusting for differences in age, parity, and hypertensive disorders of pregnancy (12.1{\%} vs 13.1{\%}, adjusted RR 0.84; 95{\%} CI 0.61-1.17), nor were they more likely to have severe respiratory complications or prolonged NICU admission.CONCLUSION:Maternal GDM is not associated with increased neonatal respiratory morbidity in this study population who were at high risk for late preterm birth.",
author = "Werner, {Erika F.} and Romano, {Megan E.} and Rouse, {Dwight J.} and Grecio Sandoval and Cynthia Gyamfi-Bannerman and Blackwell, {Sean C.} and Tita, {Alan T.N.} and Reddy, {Uma M.} and Lucky Jain and Saade, {George R.} and Iams, {Jay D.} and Clark, {Erin A.S.} and Thorp, {John M.} and Chien, {Edward K.} and Peaceman, {Alan M} and Swamy, {Geeta K.} and Norton, {Mary E.} and Casey, {Brian M.} and Caritis, {Steve N.} and Tolosa, {Jorge E.} and Yoram Sorokin",
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Werner, EF, Romano, ME, Rouse, DJ, Sandoval, G, Gyamfi-Bannerman, C, Blackwell, SC, Tita, ATN, Reddy, UM, Jain, L, Saade, GR, Iams, JD, Clark, EAS, Thorp, JM, Chien, EK, Peaceman, AM, Swamy, GK, Norton, ME, Casey, BM, Caritis, SN, Tolosa, JE & Sorokin, Y 2019, 'Association of Gestational Diabetes Mellitus with Neonatal Respiratory Morbidity', Obstetrics and gynecology, vol. 133, no. 2, pp. 349-353. https://doi.org/10.1097/AOG.0000000000003053

Association of Gestational Diabetes Mellitus with Neonatal Respiratory Morbidity. / Werner, Erika F.; Romano, Megan E.; Rouse, Dwight J.; Sandoval, Grecio; Gyamfi-Bannerman, Cynthia; Blackwell, Sean C.; Tita, Alan T.N.; Reddy, Uma M.; Jain, Lucky; Saade, George R.; Iams, Jay D.; Clark, Erin A.S.; Thorp, John M.; Chien, Edward K.; Peaceman, Alan M; Swamy, Geeta K.; Norton, Mary E.; Casey, Brian M.; Caritis, Steve N.; Tolosa, Jorge E.; Sorokin, Yoram.

In: Obstetrics and gynecology, Vol. 133, No. 2, 01.02.2019, p. 349-353.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association of Gestational Diabetes Mellitus with Neonatal Respiratory Morbidity

AU - Werner, Erika F.

AU - Romano, Megan E.

AU - Rouse, Dwight J.

AU - Sandoval, Grecio

AU - Gyamfi-Bannerman, Cynthia

AU - Blackwell, Sean C.

AU - Tita, Alan T.N.

AU - Reddy, Uma M.

AU - Jain, Lucky

AU - Saade, George R.

AU - Iams, Jay D.

AU - Clark, Erin A.S.

AU - Thorp, John M.

AU - Chien, Edward K.

AU - Peaceman, Alan M

AU - Swamy, Geeta K.

AU - Norton, Mary E.

AU - Casey, Brian M.

AU - Caritis, Steve N.

AU - Tolosa, Jorge E.

AU - Sorokin, Yoram

PY - 2019/2/1

Y1 - 2019/2/1

N2 - OBJECTIVE:To assess neonatal respiratory morbidity in pregnancies with and without gestational diabetes mellitus (GDM) at imminent risk of late preterm delivery in a modern U.S. cohort.METHODS:Secondary analysis of a randomized placebo-controlled trial in which women with singleton pregnancies at high risk for delivery between 34 0/7 and 36 5/7 weeks of gestation were allocated to betamethasone or placebo. The primary outcome for the trial and this secondary analysis was a composite outcome of neonatal respiratory morbidity in the first 72 hours of life. Secondary outcomes included neonatal severe respiratory complications, neonatal intensive care unit (NICU) admission greater than or equal to 3 days, and hyperbilirubinemia. We examined associations between neonatal morbidities and GDM status after adjustment for baseline differences and study group allocation using modified Poisson regression. Models incorporating a product interaction term between GDM status and treatment arm (betamethasone or placebo) were also evaluated.RESULTS:Of the 2,831 women enrolled in the trial, 306 (10.8%) had GDM. Women with GDM were significantly older and were more likely to be parous and to have hypertensive disorders of pregnancy than those without GDM, but they were similar regarding race, gestational age at randomization (35.6 weeks) and at delivery (36.1 weeks), and study group assignment. Neonates born to women with GDM were no more likely to meet the primary outcome than those born to women without GDM, even after adjusting for differences in age, parity, and hypertensive disorders of pregnancy (12.1% vs 13.1%, adjusted RR 0.84; 95% CI 0.61-1.17), nor were they more likely to have severe respiratory complications or prolonged NICU admission.CONCLUSION:Maternal GDM is not associated with increased neonatal respiratory morbidity in this study population who were at high risk for late preterm birth.

AB - OBJECTIVE:To assess neonatal respiratory morbidity in pregnancies with and without gestational diabetes mellitus (GDM) at imminent risk of late preterm delivery in a modern U.S. cohort.METHODS:Secondary analysis of a randomized placebo-controlled trial in which women with singleton pregnancies at high risk for delivery between 34 0/7 and 36 5/7 weeks of gestation were allocated to betamethasone or placebo. The primary outcome for the trial and this secondary analysis was a composite outcome of neonatal respiratory morbidity in the first 72 hours of life. Secondary outcomes included neonatal severe respiratory complications, neonatal intensive care unit (NICU) admission greater than or equal to 3 days, and hyperbilirubinemia. We examined associations between neonatal morbidities and GDM status after adjustment for baseline differences and study group allocation using modified Poisson regression. Models incorporating a product interaction term between GDM status and treatment arm (betamethasone or placebo) were also evaluated.RESULTS:Of the 2,831 women enrolled in the trial, 306 (10.8%) had GDM. Women with GDM were significantly older and were more likely to be parous and to have hypertensive disorders of pregnancy than those without GDM, but they were similar regarding race, gestational age at randomization (35.6 weeks) and at delivery (36.1 weeks), and study group assignment. Neonates born to women with GDM were no more likely to meet the primary outcome than those born to women without GDM, even after adjusting for differences in age, parity, and hypertensive disorders of pregnancy (12.1% vs 13.1%, adjusted RR 0.84; 95% CI 0.61-1.17), nor were they more likely to have severe respiratory complications or prolonged NICU admission.CONCLUSION:Maternal GDM is not associated with increased neonatal respiratory morbidity in this study population who were at high risk for late preterm birth.

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Werner EF, Romano ME, Rouse DJ, Sandoval G, Gyamfi-Bannerman C, Blackwell SC et al. Association of Gestational Diabetes Mellitus with Neonatal Respiratory Morbidity. Obstetrics and gynecology. 2019 Feb 1;133(2):349-353. https://doi.org/10.1097/AOG.0000000000003053