{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T18:56:33Z","timestamp":1785610593215,"version":"3.56.0"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T00:00:00Z","timestamp":1641513600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine severe birth\u2010related injuries in neonates among mothers with different types of diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study based on Finnish Medical Birth Register data from 2004 to 2017. The study included singleton neonates born vaginally with cephalic presentation (<jats:italic>n\u00a0<\/jats:italic>=\u00a0623\u00a0649) after 35<jats:sup>+0<\/jats:sup>\u00a0weeks of gestation. The primary outcome variable was severe birth injury. Incidences, crude and adjusted odds ratios, and probabilities in regression analysis were calculated for different types of diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 1952\/623 649 (0.3%) severe birth injuries of which brachial plexus injury occurred most frequently. The injury incidence was highest in neonates of women with type 1 or type 2 diabetes, 42\/1659 (2.5%) and 10\/548 (1.8%), respectively. For gestational diabetes, the injury incidence was comparable to non\u2010diabetic women: 422\/77 810 (0.5%) and 1478\/543 632 (0.3%), respectively. Shoulder dystocia, high birthweight, and vacuum\u2010assisted delivery were associated with the highest probability for injury. Birthweight and obesity had a stronger impact on injury risk in women with pregestational diabetes compared to other pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Neonates of women with pregestational diabetes have a higher risk for severe birth injury than other neonates. The injury risk in neonates delivered by women with gestational diabetes or non\u2010diabetic women is generally low.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14073","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T13:14:31Z","timestamp":1640006071000},"page":"195-203","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Severe birth injuries in neonates and associated risk factors for injury in mothers with different types of diabetes in Finland"],"prefix":"10.1002","volume":"159","author":[{"given":"Maiju","family":"Kekki","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Tampere University Hospital  Tampere Finland"},{"name":"Center for Child, Adolescent and Maternal Health Research Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kati","family":"Tihtonen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Tampere University Hospital  Tampere Finland"},{"name":"Center for Child, Adolescent and Maternal Health Research Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Salonen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Department of Pediatric and Adolescent Surgery Tampere University Hospital  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Topias","family":"Koukkula","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Department of Orthopaedics and Traumatology Tampere University Hospital  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Information Services Department THL Finnish Institute for Health and Welfare  Helsinki Finland"},{"name":"Department of Molecular Medicine and Surgery Karolinska Institute and Region Stockholm Academic Primary Health Care Centre  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannele","family":"Laivuori","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Tampere University Hospital  Tampere Finland"},{"name":"Center for Child, Adolescent and Maternal Health Research Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Institute for Molecular Medicine Finland Helsinki Institute of Life Science University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuomas T.","family":"Huttunen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Tampere University Heart Hospital Tampere University Hospital  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.15267"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.171076"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-020578"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-017-4206-6"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(20)30406-X"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12059"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13843"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12521"},{"key":"e_1_2_10_10_1","first-page":"1","article-title":"Rising trends in the incidence of shoulder dystocia and development of a novel shoulder dystocia risk score tool: a nationwide 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