When is the risk for shoulder dystocia increased in mothers with gestational diabetes mellitus (GDM)?

Updated: Apr 29, 2020
  • Author: Thomas R Moore, MD; Chief Editor: George T Griffing, MD  more...
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Answer

Answer

More recent data from the Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) trial demonstrated a positive relationship between severity of maternal fasting hyperglycemia and risk of shoulder dystocia, with a 1 mmol increase in fasting glucose leading to a 2.09 relative risk for shoulder dystocia. [40]

In addition, there appears to be a role for excessive fetal insulin levels in mediating accelerated fetal growth. In the study by Simmons et al which compared umbilical cord sera in infants of diabetic mothers and controls, the heavier, fatter babies from diabetic pregnancies were also hyperinsulinemic. [41]


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