Objective: To evaluate the outcomes of vacuum-assisted vaginal deliveries (VAD) among neonates of mothers with
gestational diabetes mellitus (GDM). Study design: Retrospective cohort study of women with singleton gestation ≥37 + 0 weeks of gestation who underwent VAD at a single, tertiary, medical center (2007-2014). Women with GDM and their neonates were compared to women without diabetes and their neonates. Composite neonatal outcome was defined as ≥1 of the following:
shoulder dystocia, 5-min Apgar score <7,
asphyxia, seizure, subgaleal, subarachnoid or
subdural hemorrhage, fracture of the clavicle, humerus or skull, or
Erb's palsy. Results: Overall, 251 (5.2%) women with GDM were compared with 4534 (94.8%) women without GDM. Women with GDM were older, delivered earlier, with higher rates of mild
preeclampsia and
induction of labor. Their neonates had higher mean
birth weight percentile, and higher rates of
hypoglycemia,
phototherapy, fracture of the humerus (3.2 versus 1.1%, aOR 2.95, 95%CI 1.38-6.30), and
subarachnoid hemorrhage (1.2 versus 0.3%, aOR 4.56, 95%CI 1.28-16.26). No difference was found with regards to the composite neonatal outcome (9.2 versus 11.1%, p = .34). Conclusions: GDM is associated with a higher risk for certain
birth injuries in VAD at ≥37 + 0 weeks of gestation, yet the overall risk of adverse neonatal outcomes is comparable to women without GDM.