Rate of spontaneous preterm delivery between gestational diabetes and normal pregnancy: A retrospective cohort study

Abstract

Background Preterm delivery has been reported to increase among women with gestational diabetes (GDM) but with conflicting results. Understand the relationship between the 2 conditions could help in better care of GDM and possibly minimize the risk of preterm delivery Therefore, the primary objective was to compare the rate of spontaneous preterm delivery between GDM and normal pregnancy. Moreover, pregnancy outcomes and associated risk factors for spontaneous preterm delivery were evaluated. Methods A retrospective cohort study was conducted in 120 GDM and 480 normal pregnant women. All women received GDM screening with 50-g GCT and 100-g OGTT at first visit and repeated at 24–28 weeks. Data was retrieved from medical records, including baseline and obstetric characteristics, preterm risks, GDM risks, and pregnancy outcomes. Spontaneous preterm birth was defined as delivery before 37 completed weeks of gestation that had been preceded by spontaneous labor. Results GDM women were more likely to be \(\ge\)30 years (p = 0.032), and have previous GDM (p = 0.013). Incidence of overall preterm delivery was significantly higher in GDM women (17.5% vs. 8.5%, p = 0.004) as well as incidence of spontaneous preterm delivery (15.8% vs. 7.1%, p = 0.004). GDM women had less gestational weight gain (p < 0.001) and were less likely to have excessive weight gain (p = 0.002). GDM women were more likely to deliver LGA (p = 0.02) and macrosomic infants (p = 0.027). Neonatal hypoglycemia was significantly more common among GDM (p = 0.013). Multivariate analysis showed that previous preterm birth and GDM independently increased risk of spontaneous preterm delivery (adjusted OR 2.56, CI 1.13–5.79, p 0.024 and adjusted OR 2.15, CI 1.2–3.84, p 0.010, respectively). Conclusion GDM and previous preterm birth significantly increased the risk of spontaneous preterm delivery. GDM also increased the risk of LGA, macrosomia, and neonatal hypoglycemia.