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Severe birth injuries in neonates and associated risk factors for injury in mothers with different types of diabetes in Finland
Author(s) -
Kekki Maiju,
Tihtonen Kati,
Salonen Anne,
Koukkula Topias,
Gissler Mika,
Laivuori Hannele,
Huttunen Tuomas T.
Publication year - 2022
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.14073
Subject(s) - medicine , shoulder dystocia , obstetrics , gestational diabetes , incidence (geometry) , birth injury , birth weight , diabetes mellitus , gestation , gestational age , pregnancy , birth trauma , odds ratio , retrospective cohort study , brachial plexus injury , pediatrics , surgery , brachial plexus , endocrinology , genetics , physics , optics , biology
Objective To examine severe birth‐related injuries in neonates among mothers with different types of diabetes. Methods Retrospective cohort study based on Finnish Medical Birth Register data from 2004 to 2017. The study included singleton neonates born vaginally with cephalic presentation ( n = 623 649) after 35 +0 weeks of gestation. The primary outcome variable was severe birth injury. Incidences, crude and adjusted odds ratios, and probabilities in regression analysis were calculated for different types of diabetes. Results There were 1952/623 649 (0.3%) severe birth injuries of which brachial plexus injury occurred most frequently. The injury incidence was highest in neonates of women with type 1 or type 2 diabetes, 42/1659 (2.5%) and 10/548 (1.8%), respectively. For gestational diabetes, the injury incidence was comparable to non‐diabetic women: 422/77 810 (0.5%) and 1478/543 632 (0.3%), respectively. Shoulder dystocia, high birthweight, and vacuum‐assisted delivery were associated with the highest probability for injury. Birthweight and obesity had a stronger impact on injury risk in women with pregestational diabetes compared to other pregnancies. Conclusion Neonates of women with pregestational diabetes have a higher risk for severe birth injury than other neonates. The injury risk in neonates delivered by women with gestational diabetes or non‐diabetic women is generally low.