In Australia, GDM prevalence has tripled from 5.4% in 2009 to 17.9% in 2022, with global rates affecting up to 25% of pregnancies. GDM has overtaken prolonged pregnancy as the leading indication for induction of labour (IOL). Despite this rise, GDM alone is not a recognised clinical indication for IOL, and the increasing use of IOL in women with GDM presents a growing challenge in maternity care.
Current evidence on optimal birth timing for women with GDM is inconsistent, leading to variation in clinical practice, potentially compromising care. The growing trend toward IOL appears to be driven by clinician interpretation, clinical caution, and inconsistencies across guidelines.
Clinical Practice Guidelines (CPGs) are designed to provide evidence-based recommendations to support safe, high-quality care. A review of national and international CPGs identified substantial inconsistencies in labour timing recommendations for women with GDM. Some recommend expectant management, while others advise IOL from between 38 to 40+10 weeks.
This presentation shares findings from a scoping review, the first phase of a PhD study. The review examined CPGs from 2015 onwards, specifically addressing the recommendations on timing of labour for women with GDM. The review analysed these guidelines and recommendations and evaluated their methodological quality. Through a textual descriptive synthesis, variances in recommendations were identified and analysed against evidence-based criteria.
By highlighting these inconsistencies, the presentation aims to prompt clinicians to critically evaluate the guidelines informing their practice and to support more informed, evidence-based, and woman-centred decision-making when providing care to women with GDM.