{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T23:18:57Z","timestamp":1785799137022,"version":"3.56.0"},"reference-count":12,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The Big Baby Trial found that early induction in patients with suspected large-for-gestational-age (LGA) fetuses reduced shoulder dystocia and prelabor cesarean rates. However, it excluded patients with pregestational diabetes mellitus (PGDM), who are at increased risk of adverse outcomes. We sought to evaluate delivery outcomes by gestational week in patients with PGDM and LGA fetuses.<\/jats:p>\n                  <jats:p>This was a population-based cohort study of nulliparous, nonanomalous, singleton, live births complicated by PGDM and LGA between 360\/7 and 416\/7 weeks using the U.S. Natality Vital Statistics Database from 2015 to 2023. Births following a prior cesarean delivery were excluded. Planned delivery group included births at each completed week from 36 to 40 weeks that underwent labor induction or scheduled cesarean delivery, excluding spontaneous labor. Expectant management group included all births that delivered in subsequent weeks (e.g., planned birth 360\/7\u2013366\/7 compared with all births \u2265370\/7 weeks). The primary outcome was cesarean delivery rate and the secondary outcome was a composite of adverse neonatal outcomes (5-min Apgar score\u2009&lt;\u20097, assisted neonatal ventilation\u2009&gt;\u20096\u2009hours, neonatal seizures, 10-min Apgar score of 0, and neonatal death). Outcomes were compared between groups at each week using multivariable logistic regression.<\/jats:p>\n                  <jats:p>There were 9,805 births analyzed. Cesarean delivery rate ranged from 77 to 87%. After adjusting for baseline differences between groups, planned delivery at 39 weeks was associated with decreased odds of cesarean delivery than expectantly managed pregnancies. After 38 weeks, planned delivery and expectant management had similar odds of cesarean delivery and neonatal morbidity.<\/jats:p>\n                  <jats:p>In pregnancies complicated by PGDM and LGA, planned delivery after 39 weeks was associated with lower odds of cesarean delivery compared with expectant management. Planned delivery at 38 weeks had similar odds of cesarean delivery and neonatal morbidity. These data suggest that providers should be cautious expectantly managing these pregnancies past 38 weeks.<\/jats:p>","DOI":"10.1055\/a-2854-5895","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:34:31Z","timestamp":1777588471000},"page":"1066-1071","source":"Crossref","is-referenced-by-count":1,"title":["The Effect of Delivery Timing on Cesarean Delivery Rate in Pregnancies Complicated by Pregestational Diabetes and Large-for-Gestational-Age Neonate"],"prefix":"10.1055","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1783-3727","authenticated-orcid":false,"given":"Heather","family":"Ward","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavisha","family":"Khanuja","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Rodney","family":"McLaren","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0215-6610","authenticated-orcid":false,"given":"Emily Schlussel","family":"Markovic","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huda","family":"Al-Kouatly","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"issue":"06","key":"ref1","first-page":"1","article-title":"Trends and characteristics in prepregnancy diabetes\u2014United States, 2016\u20132021","volume":"72","author":"E CW Gregory","year":"2023","journal-title":"Natl Vital Stat Rep"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"e228","DOI":"10.1097\/AOG.0000000000002960","article-title":"ACOG practice bulletin no. 201: pregestational diabetes mellitus","volume":"132","author":"American College of Obstetricians and Gynecologists' Committee on Practice Bulletins\u2014Obstetrics","year":"2018","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1093\/ejendo\/lvaf116","article-title":"Preexisting diabetes and pregnancy: an Endocrine Society and European Society of Endocrinology joint clinical practice guideline","volume":"193","author":"J A Wyckoff","year":"2025","journal-title":"Eur J Endocrinol"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"e202605","DOI":"10.1001\/jamanetworkopen.2020.2605","article-title":"Association of birth by cesarean delivery with obesity and type 2 diabetes among adult women","volume":"3","author":"J E Chavarro","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"S 01","key":"ref6","doi-asserted-by":"crossref","first-page":"1367-P","DOI":"10.2337\/db20-1367-P","article-title":"Risk and indications for cesarean delivery among women with diabetes in the United States","volume":"69","author":"J Grash","year":"2020","journal-title":"Diabetes"},{"issue":"26","key":"ref7","doi-asserted-by":"crossref","first-page":"10375","DOI":"10.1080\/14767058.2022.2128653","article-title":"Cesarean delivery rates and indications in pregnancies complicated by diabetes","volume":"35","author":"K LW Olerich","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"11","key":"ref8","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1111\/1471-0528.18276","article-title":"Pregestational diabetes and duration of active labour compared with non-diabetic women: a population-based cohort study","volume":"132","author":"S Nevander","year":"2025","journal-title":"BJOG"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1743","DOI":"10.1016\/S0140-6736(25)00162-X","article-title":"Induction of labour versus standard care to prevent shoulder dystocia in fetuses suspected to be large for gestational age in the UK (the Big Baby trial): a multicentre, open-label, randomised controlled trial","volume":"405","author":"J Gardosi","year":"2025","journal-title":"Lancet"},{"issue":"11","key":"ref10","doi-asserted-by":"crossref","first-page":"196","DOI":"10.4239\/wjd.v2.i11.196","article-title":"Consequences of gestational and pregestational diabetes on placental function and birth weight","volume":"2","author":"A Vambergue","year":"2011","journal-title":"World J Diabetes"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"9017","DOI":"10.1038\/s41598-024-59465-x","article-title":"Maternal and foetal complications of pregestational and gestational diabetes: a descriptive, retrospective cohort study","volume":"14","author":"M Oros Ruiz","year":"2024","journal-title":"Sci Rep"},{"issue":"9987","key":"ref12","doi-asserted-by":"crossref","first-page":"2600","DOI":"10.1016\/S0140-6736(14)61904-8","article-title":"Induction of labour versus expectant management for large-for-date fetuses: a randomised controlled trial","volume":"385","author":"M Boulvain","year":"2015","journal-title":"Lancet"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1111\/1471-0528.14435","article-title":"Induction of labour for suspected macrosomia at term in non-diabetic women: a systematic review and meta-analysis of randomized controlled trials","volume":"124","author":"E R Magro-Malosso","year":"2017","journal-title":"BJOG"}],"container-title":["American Journal of 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