Gestational Diabetes increases Fetal Hypoxia risk during lab
Gestational diabetes mellitus (GDM) is associated with an increased risk of fetal hypoxia during labor, finds a recent study in the journal Acta Diabetologica. Also, the study found that gestational diabetes increased the susceptibility of the fetus to intrapartal hypoxia, regardless of the size of the fetus.

The aim of the present study was to evaluate whether an association exists between the recently reported ZigZag pattern (FHR baseline amplitude changes of > 25 bpm with a duration of 2–30 min) and asphyxia-related neonatal outcomes in GDM pregnancies.

Intrapartal CTGs were recorded in a one-year cohort of 5150 singleton childbirth. The following CTG changes were evaluated: ZigZag pattern, saltatory pattern, late decelerations, episodes of tachycardia and bradycardia, reduced variability, and uterine tachysystole. The cohort was divided into three groups: women with GDM, women with normal oral glucose tolerance test (OGTT), and women with no OGTT performed. Umbilical artery (UA) blood gases, Apgar scores, neonatal respiratory distress, and neonatal encephalopathy were used as outcome variables.

GDM was diagnosed in 624, OGTT was normal in 4115, and OGTT was not performed in 411 women. Hypoxia-related ZigZag patterns and late decelerations of FHR, as well as a greater risk of fetal asphyxia, were observed in those with GDM compared with those without GDM.

In conclusion, GDM is associated with intrapartal ZigZag pattern and late decelerations, cord blood acidemia, and low 5-min Apgar scores at birth indicating the increased occurrence of fetal hypoxia in GDM pregnancies.