Comparison of Labor Characteristics and Maternal-Neonatal Outcomes in Induced Labor Between Women with A1 Gestational Diabetes Mellitus and Normoglycemic Controls.

BACKGROUND: This study compared labor characteristics and maternal-neonatal outcomes between pregnant women with diet-controlled (A1) gestational diabetes mellitus (GDM) and normoglycemic women, within a cohort of women undergoing induction of labor (IOL) at term. Furthermore, we aimed to identify risk factors associated with cesarean section (CS) in this specific population. MATERIAL AND METHODS: A total of 686 pregnant women were enrolled and divided into an A1 GDM group (n=256) and a non-GDM control group (n=430). Propensity score matching (PSM) was used to adjust for maternal age, BMI, gravidity, parity, and Bishop score, resulting in 254 matched pairs. Labor induction characteristics, clinical interventions, and maternal and neonatal outcomes were compared. Risk factors for CS were analyzed using univariate and multivariate logistic regression. RESULTS: The A1 GDM group had higher rates of episiotomy and postpartum blood loss, and greater fetal weight (P<0.05), but no significant difference in CS rates (9.8% vs. 11.4%) or most neonatal outcomes. Multivariate analysis showed that advanced maternal age (OR 1.177, 95% CI 1.089-1.272), nulliparity (OR 0.110, 95% CI 0.053-0.231), and lower Bishop score (OR 0.605, 95% CI 0.442-0.828) were independent risk factors for CS, while A1 GDM was not. CONCLUSIONS: In this cohort of women undergoing IOL at term, pregnancy outcomes for those with well-managed A1 GDM were comparable to non-GDM controls. After adjustment for confounders, A1 GDM was not observed to be an independent risk factor for CS, instead, maternal age, parity, and cervical readiness were the primary determinants of delivery mode.