Incidence of Trauma during Birth to Neonates Born to Mothers with Gestational Diabetes Mellitus

Abstract

Gestational Diabetes Mellitus (GDM) is defined as glucose intolerance that occurs during pregnancy. The incidence of GDM has been on the rise and is a significant cause of various consequences for both the mother and infant. Such consequences include birth trauma. Factors such as shoulder dystocia and fetal macrosomia can increase the incidence of birth trauma. Additionally, GDM is a major cause of fetal macrosomia, influencing the intrapartum delivery method. This study aims to investigate the incidence of birth trauma in mothers with and without GDM. A total of 10,865 patients from King Hamad University Hospital (KHUH) were included, and their files were then further stratified only to include neonates with evidence of birth trauma. A total of 64 patients were found to fit the inclusion criteria. The study looked at GDM status, gestational age, birth weight, length, head circumference, mode of delivery, presentation of the baby before delivery, assistance during delivery, and maternal/neonatal trauma. Maternal trauma rates were found to be statistically significant within the population of the Kingdom of Bahrain. An increased incidence of maternal trauma was observed in the non-GDM group, with 56.3% of the patients requiring an episiotomy or having a complication of a vaginal laceration. Regarding the incidence of birth traumas in the GDM group, they presented most commonly with cephalohematoma or Erb’s palsy, whereas the non-GDM group most commonly presented with cephalohematoma. The incidence of birth trauma due to GDM has seldom been researched in the existing literature. However, it has been noted that factors such as macrosomia can increase the likelihood of birth trauma. The general incidence of neonatal birth trauma has been reported to be 2.7%, which is reassuring; however, it is essential to investigate further the effect of GDM on the rates of birth trauma using large population cohorts.