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Objective To examine the risk of neonatal respiratory morbidity associated with gestational and pregestational diabetes, accounting for the prematurity-associated risk using a propensity score analysis. Study design In a retrospective study including 222,978 singleton pregnancies, delivering at 240/7 to 416/7 weeks (2002-2008), we calculated a probability to deliver at term (≥37 weeks of gestation). Outcomes were stratified by the probability to deliver at term (>0.8 and ≤0.8). Adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) were calculated. Results Gestational and pregestational diabetes complicated 5.1 and 1.5% of pregnancies, respectively, and were associated with increased risks of neonatal respiratory morbidity compared with women without diabetes regardless of probability to deliver at term. However, these risks tended to be higher with a higher probability to deliver at term: respiratory distress syndrome (aOR: 1.5; 95% CI: 1.3-1.7 and aOR: 3.1; 95% CI: 2.6-3.7); transient tachypnea of newborn (aOR: 1.5; 95% CI: 1.3-1.6 and aOR: 2.2; 95% CI: 1.9-2.6); and apnea (aOR: 1.5; 95% CI: 1.2-1.7 and aOR: 3.2; 95% CI: 2.6-3.9, for gestational and pregestational at term, respectively). Conclusion Diabetes was associated with increased risk of neonatal respiratory morbidity beyond what can be attributed to prematurity. Neonatal respiratory morbidities were increased with pregestational diabetes compared with gestational diabetes. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the incidence and risk of complications associated with a fetal scalp electrode and to determine whether its application in the setting of operative vaginal delivery was associated with increased neonatal morbidity.Design: Retrospective cohort study.Setting: Twelve clinical centers with 19 hospitals across nine American Congress of Obstetricians and Gynecologists US districts.Population: Women in the USA.Methods: We evaluated 171 698 women with singleton deliveries ≥ 23 weeks of gestation in a secondary analysis of the Consortium on Safe Labor study between 2002 and 2008, after excluding conditions that precluded fetal scalp electrode application such as prelabour caesarean delivery. Secondary analysis limited to operative vaginal deliveries ≥ 34 weeks of gestation was also performed.Main Outcome Measures: Incidences and adjusted odds ratios with 95% confidence intervals of neonatal complications were calculated, controlling for maternal characteristics, delivery mode and pregnancy complications.Results: Fetal scalp electrode was used in 37 492 (22%) of deliveries. In non-operative vaginal delivery, fetal scalp electrode was associated with increased risk of injury to scalp due to birth trauma (1.2% versus 0.9%; adjusted odds ratios 1.62; 95% confidence intervals 1.41-1.86) and cephalohaematoma (1.0% versus 0.9%; adjusted odds ratios 1.57; 95% confidence intervals 1.36-1.83). Neonatal complications were not significantly different comparing fetal scalp electrode with vacuum-assisted vaginal delivery and vacuum-assisted vaginal delivery alone or comparing fetal scalp electrode with forceps-assisted vaginal delivery and forceps-assisted vaginal delivery alone.Conclusions: We found increased neonatal morbidity with fetal scalp electrode though the absolute risk was very low. It is possible that these findings reflect an underlying indication for its use. Our findings support the use of fetal scalp electrodes when clinically indicated.Tweetable Abstract: Neonatal risks associated with fetal scalp electrode use were low (injury to scalp 1.2% and cephalohaematoma 1.0%). [ABSTRACT FROM AUTHOR]