Sean C. Blackwell, Sonia S. Hassan, Honor W. Wolfe, Jodi Michaelson, Stanley M. Berry, Yoram Sorokin
Why are cesarean delivery rates so high in diabetic pregnancies?
Aims: The purpose of this study was to examine factors
relevant to mode of delivery in term pregnancies complicated
by gestational and pre-gestational diabetes.
Methods: A retrospective chart review of term (? 37
weeks) singleton pregnancies complicated by Class A2
through Class R pregnancies which delivered from
1991–1997 was performed. Exclusion criteria were
prior cesarean delivery, non-vertex presentation, fetal
structural defects, or any contraindications to vaginal
delivery. Maternal and fetal factors relevant to mode of
delivery were examined and compared. Stepwise logistic
regression analysis was performed to examine
factors predictive of delivery mode.
Results: A total of 148 patients met study criteria. Induction
rates were 60.9% for gestational and 79.8% for
pre-gestational diabetics. The overall cesarean delivery
rate by Diabetes Class for A2, B, C, D–F pregnancies
was 20.3 %, 40 %, 37 %, and 57.1% respectively. In
Class A2 pregnancies no factor was associated with cesarean
delivery and only nulliparity (p 5 0.03) was associated
in Class B–F pregnancies.
Conclusions: These results suggest that physician
factors may play an important role in the risk for cesarean
delivery in our diabetic population.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 28, 08/2000
Pages: 316 - 320
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