RESUMO
PURPOSE: To evaluate if gestational diabetes (GD) exposes neonates delivered after 34 weeks to an increased risk of severe neonatal respiratory failure (NRF). METHODS: Data from 3,237 women who delivered after 34 weeks with systematic screening for GD were analyzed. Diagnosis of severe NRF required the association of clinical and radiological criteria with a minimum of 24 h of ventilation and admission to neonatal intensive care unit. RESULTS: A total of 166 (5.1%) cases of GD were identified. Severe NRF was diagnosed in 7 (4.21%) cases among women with GD as compared to 13 (0.42%) in others (p < 0.001). The rate of severe NRF was also significantly higher in cases of premature delivery (p < 0.001), fetal growth retardation (p < 0.001), and cesarean section (p = 0.005). After adjustment for these variables, GD was identified as an independent risk factor for NRF (AOR 11.55, 95% CI 3.9-33.9, p < 0.001). Two other risk factors were also identified: late preterm delivery (AOR 6.13, 95% CI 1.8-21.2, p = 0.004); and hypotrophy (AOR 9.16, 95% CI 2.7-30.5, p < 0.001). CONCLUSIONS: GD is an independent risk factor for severe NRF after 34 weeks. Neonates from such pregnancies should be monitored carefully.