Gestational diabetes mellitus: a risk factor for non-elective cesarean section

J Obstet Gynaecol Res. 2012 Jan;38(1):154-9. doi: 10.1111/j.1447-0756.2011.01659.x. Epub 2011 Oct 14.


Aim: To assess whether gestational diabetes mellitus (GDM) is associated with non-elective cesarean section.

Material and methods: A retrospective cohort study was conducted at the Department of Obstetrics of a level III hospital. Between January 2004 and November 2007, women admitted in labor or with spontaneous rupture of membranes, at term, and with a singleton cephalic presenting fetus were eligible. From these, 220 women with GDM and 660 glucose-tolerant women, delivered immediately after, were selected. The association between GDM and non-elective cesarean was estimated using modified Poisson regression analysis. Relative risks were adjusted for age, pre-pregnancy body mass index, gestational weight gain, previous cesarean, gestational age at delivery and birthweight.

Results: Non-elective cesarean section rate for women with GDM was 19.5% compared to 13.5% for non-diabetic women. The crude relative risk of cesarean section was 1.45 (95% CI 1.04-2.02) for women with GDM. After adjustment for confounders, the association between GDM and non-elective cesarean section remained positive and statistically significant (RR = 1.52; 95% CI 1.06-2.16). No significant differences in cesarean indications were found between the two groups.

Conclusion: GDM was disclosed as a risk factor for non-elective cesarean section. Knowledge of the condition may have influenced obstetrical practice, favoring cesarean delivery.

MeSH terms

  • Adult
  • Birth Weight
  • Cesarean Section*
  • Diabetes, Gestational / diagnosis
  • Diabetes, Gestational / physiopathology*
  • Female
  • Fetal Macrosomia / diagnosis
  • Fetal Macrosomia / physiopathology*
  • Glucose Tolerance Test
  • Humans
  • Pregnancy
  • Pregnancy Outcome
  • Retrospective Studies
  • Risk Factors