Association between 5 min Apgar scores and planned mode of delivery in diabetic pregnancies.

OBJECTIVE

Due to the high incidence of neonatal complications in diabetic pregnancies, the aim of our study was to investigate whether elective cesarean section could prevent adverse neonatal outcome.

DESIGN

Population-based study.

SETTING

Data were extracted from the Swedish Medical Birth Registry.

POPULATION

All women (n=13 491) with diabetic pregnancies during the period 1990-2007.

METHODS

Neonatal outcome in diabetic pregnancies was compared after elective cesarean section at 38 completed gestational weeks with planned vaginal delivery at 39 completed weeks of gestation or later. Odds ratios with 95% confidence intervals for Apgar scores <7 at 5 min after birth were calculated using multiple logistic regression.

MAIN OUTCOME MEASURES

Apgar score <7 at 5 min after birth.

RESULTS

A significantly decreased risk of Apgar score <7 at 5 min after birth in the group who underwent an elective cesarean section at 38 completed gestational weeks was found compared with those who continued pregnancy to 39 completed weeks of gestation or more, irrespective of final mode of delivery.

CONCLUSIONS

Our results indicate a protective effect of planned cesarean section on the risk of low Apgar scores in diabetic pregnancies.