Is Gestational Diabetes Mellitus Associated with Peripartum Infections?

We investigated the association between gestational diabetes mellitus (GDM) and the rate of peripartum infections (chorioamnionitis and/or endometritis). A retrospective cohort study was conducted using data collected between January 2014 and July 2021. The study group comprised women with GDM, while the control group consisted of women without GDM, matched for age ≥ 35 Y, primiparity, pre-gestational body mass index (BMI), cesarean and vacuum deliveries, and preterm deliveries. The primary outcome was the rate of peripartum infections. Data from 1683 GDM women and 1683 matched controls were analyzed. No significant difference was observed in the rate of peripartum infections between the GDM and control groups (26 (1.5%) versus 14 (0.8%), respectively; p = 0.056), nor in the rates of other infections. After controlling for epidural analgesia rate, BMI, age, and delivery week in multivariable logistic regression, the rate of peripartum infections remained statistically insignificant between the GDM group and controls (OR 1.8, 95% CI 0.9-3.4). The main pathogens isolated in cases of peripartum infections were similar in both groups, primarily consisting of Escherichia coli and Group B Streptococcus. No difference in the rate of study outcomes was observed when vaginal and cesarean deliveries were analyzed separately. Altogether, GDM was not associated with an increased risk for peripartum infections.