Differences in umbilical cord blood gas parameters between women with and without gestational diabetes: a single-center prospective-retrospective cohort study.
Gestational diabetes mellitus (GDM) is associated with various perinatal complications and may affect neonatal acid-base status. Umbilical cord arterial blood gas (ABG) analysis provides an objective measure of fetal well-being at birth, although existing evidence on the impact of GDM on ABG parameters remains inconclusive. The objective of the study is to compare umbilical cord ABG parameters-pH, partial pressure of carbon dioxide (pCO2) and partial pressure of oxygen (pO2), base excess and bicarbonate-between pregnancies with and without GDM complications, and to evaluate the potential influence of GDM on neonatal oxygenation and acid-base balance. This single-center prospective-retrospectivecohort study was conducted in a tertiary care hospital in northern Poland and included 191 pregnant women (44 with GDM, 147 without). GDM was diagnosed based on International Association of Diabetes and Pregnancy Study Groups, World Health Organization, and national guidelines. Arterial cord blood samples were collected immediately after birth and analyzed for ABG parameters. The newborns of mothers with GDM had significantly higher pH values and significantly lower pCO2 levels compared to the controls. No significant difference was observed in pO2, base excess and bicarbonate values between the groups. These findings suggest that, in well-managed pregnancies, GDM may not lead to impaired fetal oxygenation or acidosis at birth. Our findings are consistent with the hypothesis that effective glycemic control and standardized perinatal care may mitigate the risk of neonatal acid-base disturbances. Further studies are warranted to explore the role of treatment modalities and delivery factors in shaping neonatal outcomes.