Comparing umbilical cord arterial blood gas findings in pregnancies with and without gestational diabetes mellitus following elective cesarean section: a multicenter retrospective cohort study in Iran
Abstract Background Gestational diabetes mellitus (GDM) is linked to adverse fetal outcomes like macrosomia and neonatal hypoglycemia, with its global incidence increasing. While prior research indicates GDM may impair placental function and fetal oxygen delivery, direct evidence is limited. This st...
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BMC
2025-04-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-025-07522-2 |
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| author | Fatemeh Golshahi Zufa Iqbal Zahra Hamidi Madani Zeynab Zamanpour Behrokh Sahebdel Nafiseh Saedi Somayeh Khanjani Jafar Golshahi Mahboobeh Shirazi Pegah Rashidian Mohammadamin Parsaei |
| author_facet | Fatemeh Golshahi Zufa Iqbal Zahra Hamidi Madani Zeynab Zamanpour Behrokh Sahebdel Nafiseh Saedi Somayeh Khanjani Jafar Golshahi Mahboobeh Shirazi Pegah Rashidian Mohammadamin Parsaei |
| author_sort | Fatemeh Golshahi |
| collection | DOAJ |
| description | Abstract Background Gestational diabetes mellitus (GDM) is linked to adverse fetal outcomes like macrosomia and neonatal hypoglycemia, with its global incidence increasing. While prior research indicates GDM may impair placental function and fetal oxygen delivery, direct evidence is limited. This study compares umbilical cord arterial blood gas measurements in pregnancies with and without GDM. Methods This retrospective study analyzed medical records from four hospitals in Tehran, Rasht, Ahvaz, and Isfahan in Iran, focusing on term singleton pregnancies (gestational age ≥ 37 weeks) that underwent elective cesarean sections between January and July 2024. Exclusions included maternal age < 18 or > 45 years, pre-existing diabetes, thyroid, hypertensive, malignant, metabolic, or autoimmune disorders, intrauterine growth restriction, hypertensive disorders of pregnancy, and substance use during pregnancy. GDM was diagnosed using a 75-gram oral glucose tolerance test at 24–28 weeks. Primary outcomes included umbilical cord arterial blood gas measures (potential of hydrogen [pH], partial pressure of carbon dioxide [PCO2], partial pressure of oxygen [PO2], bicarbonate [HCO3], and base deficit). The neonatal outcomes were measured as secondary outcomes. Statistical analyses utilized Chi-square, Fisher’s exact, and independent t-tests. Results Data from 430 pregnancies, including 87 with GDM, were analyzed. Pregnancies with GDM showed significantly lower pH (7.33 ± 0.08 vs. 7.36 ± 0.06, P-value = 0.006) and greater base deficit (-1.82 ± 3.79 vs. -0.50 ± 2.74 mEq/L, P-value = 0.003). However, no significant between-group differences were observed in PCO2, PO2, or HCO3 (P-value > 0.05). Furthermore, we observed no significant differences in the mean birthweight, 1-minute, or 5-minute Apgar scores (P-values > 0.05), while neonates in the GDM group required more resuscitation (28.7% vs. 12.0%, P-value < 0.001) and neonatal intensive care unit admissions (34.5% vs. 16.9%, P-value < 0.001). Conclusions Pregnancies with GDM showed higher umbilical cord blood acidity, indicating impaired placental function and reduced fetal oxygenation. These findings underscore the need for enhanced monitoring, such as regular fetal surveillance and close glycemic control, along with timely interventions like early neonatal resuscitation protocols and preparedness for neonatal intensive care unit admissions, to mitigate impaired fetal oxygenation in GDM. Trial registration Not applicable. |
| format | Article |
| id | doaj-art-8af96a438c344ffc87afe1acc668fb8f |
| institution | OA Journals |
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| language | English |
| publishDate | 2025-04-01 |
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| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-8af96a438c344ffc87afe1acc668fb8f2025-08-20T02:17:09ZengBMCBMC Pregnancy and Childbirth1471-23932025-04-0125111010.1186/s12884-025-07522-2Comparing umbilical cord arterial blood gas findings in pregnancies with and without gestational diabetes mellitus following elective cesarean section: a multicenter retrospective cohort study in IranFatemeh Golshahi0Zufa Iqbal1Zahra Hamidi Madani2Zeynab Zamanpour3Behrokh Sahebdel4Nafiseh Saedi5Somayeh Khanjani6Jafar Golshahi7Mahboobeh Shirazi8Pegah Rashidian9Mohammadamin Parsaei10Department of Ob & Gyn, Fellowship of Maternal-Fetal Medicine, Fetal & Neonatal Research Center, Yas Hospital Complex, Tehran University of Medical SciencesSchool of Medicine, Tehran University of Medical SciencesReproductive Health Research Center, Department of Obstetrics and Gynecology, School of Medicine, Guilan University of Medical SciencesDepartment of Obstetrics and Gynecology, Jundishapur University of Medical SciencesDepartment of Ob & Gyn, Fellowship of Maternal-Fetal Medicine, Fetal & Neonatal Research Center, Yas Hospital Complex, Tehran University of Medical SciencesDepartment of Ob & Gyn, Fellowship of Maternal-Fetal Medicine, Fetal & Neonatal Research Center, Yas Hospital Complex, Tehran University of Medical SciencesDepartment of Obstetrics and Gynecology, Shahid Beheshti Hospital, Isfahan University of Medical SciencesIsfahan Cardiovascular Research Center, Isfahan University of Medical SciencesDepartment of Ob & Gyn, Fellowship of Maternal-Fetal Medicine, Fetal & Neonatal Research Center, Yas Hospital Complex, Tehran University of Medical SciencesVali-e-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical SciencesBreastfeeding Research Center, Family Health Research Institute, Tehran University of Medical SciencesAbstract Background Gestational diabetes mellitus (GDM) is linked to adverse fetal outcomes like macrosomia and neonatal hypoglycemia, with its global incidence increasing. While prior research indicates GDM may impair placental function and fetal oxygen delivery, direct evidence is limited. This study compares umbilical cord arterial blood gas measurements in pregnancies with and without GDM. Methods This retrospective study analyzed medical records from four hospitals in Tehran, Rasht, Ahvaz, and Isfahan in Iran, focusing on term singleton pregnancies (gestational age ≥ 37 weeks) that underwent elective cesarean sections between January and July 2024. Exclusions included maternal age < 18 or > 45 years, pre-existing diabetes, thyroid, hypertensive, malignant, metabolic, or autoimmune disorders, intrauterine growth restriction, hypertensive disorders of pregnancy, and substance use during pregnancy. GDM was diagnosed using a 75-gram oral glucose tolerance test at 24–28 weeks. Primary outcomes included umbilical cord arterial blood gas measures (potential of hydrogen [pH], partial pressure of carbon dioxide [PCO2], partial pressure of oxygen [PO2], bicarbonate [HCO3], and base deficit). The neonatal outcomes were measured as secondary outcomes. Statistical analyses utilized Chi-square, Fisher’s exact, and independent t-tests. Results Data from 430 pregnancies, including 87 with GDM, were analyzed. Pregnancies with GDM showed significantly lower pH (7.33 ± 0.08 vs. 7.36 ± 0.06, P-value = 0.006) and greater base deficit (-1.82 ± 3.79 vs. -0.50 ± 2.74 mEq/L, P-value = 0.003). However, no significant between-group differences were observed in PCO2, PO2, or HCO3 (P-value > 0.05). Furthermore, we observed no significant differences in the mean birthweight, 1-minute, or 5-minute Apgar scores (P-values > 0.05), while neonates in the GDM group required more resuscitation (28.7% vs. 12.0%, P-value < 0.001) and neonatal intensive care unit admissions (34.5% vs. 16.9%, P-value < 0.001). Conclusions Pregnancies with GDM showed higher umbilical cord blood acidity, indicating impaired placental function and reduced fetal oxygenation. These findings underscore the need for enhanced monitoring, such as regular fetal surveillance and close glycemic control, along with timely interventions like early neonatal resuscitation protocols and preparedness for neonatal intensive care unit admissions, to mitigate impaired fetal oxygenation in GDM. Trial registration Not applicable.https://doi.org/10.1186/s12884-025-07522-2Blood gas analysisCesarean sectionGestational diabetes mellituspHUmbilical cord blood. |
| spellingShingle | Fatemeh Golshahi Zufa Iqbal Zahra Hamidi Madani Zeynab Zamanpour Behrokh Sahebdel Nafiseh Saedi Somayeh Khanjani Jafar Golshahi Mahboobeh Shirazi Pegah Rashidian Mohammadamin Parsaei Comparing umbilical cord arterial blood gas findings in pregnancies with and without gestational diabetes mellitus following elective cesarean section: a multicenter retrospective cohort study in Iran BMC Pregnancy and Childbirth Blood gas analysis Cesarean section Gestational diabetes mellitus pH Umbilical cord blood. |
| title | Comparing umbilical cord arterial blood gas findings in pregnancies with and without gestational diabetes mellitus following elective cesarean section: a multicenter retrospective cohort study in Iran |
| title_full | Comparing umbilical cord arterial blood gas findings in pregnancies with and without gestational diabetes mellitus following elective cesarean section: a multicenter retrospective cohort study in Iran |
| title_fullStr | Comparing umbilical cord arterial blood gas findings in pregnancies with and without gestational diabetes mellitus following elective cesarean section: a multicenter retrospective cohort study in Iran |
| title_full_unstemmed | Comparing umbilical cord arterial blood gas findings in pregnancies with and without gestational diabetes mellitus following elective cesarean section: a multicenter retrospective cohort study in Iran |
| title_short | Comparing umbilical cord arterial blood gas findings in pregnancies with and without gestational diabetes mellitus following elective cesarean section: a multicenter retrospective cohort study in Iran |
| title_sort | comparing umbilical cord arterial blood gas findings in pregnancies with and without gestational diabetes mellitus following elective cesarean section a multicenter retrospective cohort study in iran |
| topic | Blood gas analysis Cesarean section Gestational diabetes mellitus pH Umbilical cord blood. |
| url | https://doi.org/10.1186/s12884-025-07522-2 |
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